Guam Memorial Hospital Management Interrogated At Hearing

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Past and present issues revisited during official assessment

By Janela Buhain Carrera

HAGÅTÑA, Guam (Marianas Variety Guam, May 1, 2012) – Guam Memorial Hospital (GMH) officials were intensely scrutinized during an oversight hearing last night over the lack of epidurals and what seems to be the misuse of authority to reverse the peer review process that led to the downfall of Dr. George Macris from the hospital.

The two-hour hearing was a reconvening of an oversight hearing held last week on GMH conducted by Health and Human Services Committee Chairperson Sen. Dennis Rodriguez Jr.

Committee members were particularly interested in how a settlement was reached between GMH and Macris without an established policy or procedure in place.

The case involves a "secret" settlement in which Macris agreed to drop all charges filed in court against GMH in exchange for voiding and vacating peer review findings that led to the suspension of his hospital privileges.

Rodriguez expressed concern over GMH’s position that it chose to enter into a settlement with Macris because it was more economical than going through a lengthy and expensive judicial process.

"The representation to me [was] that entering into a global settlement is in the best interest of Guam Memorial Hospital. That’s the representation that the former GMH legal counsel had discussed with me," GMH interim Administrator Rey Vega said.

"But is that in the best interest of the other patients... who might get treated now by that physician? It’s kind of like, the rest of the people who got thrown under the bus to save my skin so that I don’t go through a lawsuit, I don’t lose my shirt in a lawsuit," Sen. Tom Ada lamented.

[PIR editor’s note: GMH management has also denied claims that the Federal Bureau of Investigation has conducted inquiries into alleged extortion and fraud activities conducted by the hospital.]

Procedures

Vice Speaker Benjamin Cruz centered his line of questioning on the procedures in place – for any physician who may have had privileges or medical licensure revoked – to remove a record with the National Practitioners Data Bank (NPDB). The NPDB is the federal repository that stores information on physicians who were involved in a medical liability settlement or judgment or whose licensure or privileges were revoked or suspended due to a peer review action.

Cruz said that based on his initial assessment, he didn’t get the impression that the three boards that were initially involved in the suspension of Macris’ privileges overturned their finding of Macris’ peer review.

"Under what authority are you reversing the position that the peer review has already made a decision on? Under what authority, besides a settlement agreement? Cite for me in the regulations where you can do this?" Cruz asked.

Vega said he has not seen the regulations nor does he know whether they exist.

"So how can you sign a global settlement removing notification and the records when you can’t cite to me the regulations which say that you can do these actions – an overturning by the court, or board of trustees or some other group? There has to be authority to be able to overturn it. Earlier, you said the only way that can be removed is if it’s overturned... I can understand if it went to trial and was overturned by the court, but it [wasn't]," Cruz said.

Disparity

Rodriguez added to the fire by expressing his dissatisfaction with what seems to be a disparity in GMH management picking and choosing battles. He explained that he knew of a "small, common person" who was terminated by the hospital but appealed his case with the Civil Service Commission, which then ordered GMH to reverse its decision and award the individual retropay. But in this situation, Rodriguez said, GMH chose to go the distance and fight the CSC’s decision in court.

"I truly understand that, senator, and I have trouble with that," Medical Director Dr. Larry Lizama said. "That’s what I want [the GMH Board of Trustees] to understand – we hear this particular case; they say politics was the one that drove this, that created this problem from this particular physician. So now what we’re doing is just righting the wrong – that’s what’s being said out there," the health chair said. "But you don’t right the wrong with another wrong."

In his defense, Vega clarified that GMH management analyzes appeals on a case-by-case basis. "We do look at the merits of the case not because they’re ‘small,’" Vega said.

"I’m not talking about a case. I’m talking about a person who didn’t have the chance to go to TV and the public," Rodriguez retorted.

Epidurals

Several GMH officials were asked to speak on the contentious lack of epidurals at the hospital.

A number of officials, including Lizama, Vega, GMH board chairman Lee Webber, anesthesiology director Dr. Reynald Lim, and assistant nursing administrator Christine Tuquero, explained that the current lack of epidurals was the result of a miscommunication.

GMH officials each explained that in its efforts to address Gov. Eddie Calvo’s concerns in a February 2011 speech over the lack of epidurals, the hospital attempted to expeditiously order infusion pumps that would administer the epidural.

Webber said the pumps were ordered last December and was told it would be operational by March. Then, there was "some confusion" as to the ordering of the pumps and training of individuals.

All GMH officials attempted to explain that while it is not GMH’s intent to make the availability of epidurals a "standard" service, they hope to make it available upon request with a dedicated anesthesiologist to monitor the patient exclusively.

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