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The Orange County Register (California)
Jan 02, 2004
by CHRIS KNAP, The Orange County Register
Investigation into Chambi continues;
Patients look to Medical Board for clarity on doctor who's lost or given up privileges at 3 O.C. hospitals.Three months after Dr. Israel Chambi lost his clinical privileges at Western Medical Center-Santa Ana, questions remain for hundreds of the neurosurgeon's patients.
Chambi has lost or surrendered privileges or positions at three Orange County hospitals.
But the Medical Board of California has not taken action against his license. Officials at the board said Wednesday that their investigation of Chambi continues. But they declined to put a time frame on their work.
In the meantime, Chambi continues to practice, albeit at a smaller hospital, Tustin Medical Center.
His attorneys say he has done nothing wrong, that he is appealing his suspension at Western Medical Center and that he will be vindicated.
"I can tell you this: There has been no effort by the Med ical Board to go into court and try to stop him from practicing, as they did with the (heart) doctors in Redding,'' said Michael Zuk, an attorney for Chambi.
Chambi was the subject of a Register investigation in May that revealed more than 30 accusations of malpractice, unnecessary surgery and wrongful death over 10 years. The total number of lawsuits has since climbed to 39. In some of the cases, patients were left disfigured or disabled by surgery that other doctors said was not needed. Ten patients won settlements or verdicts totaling more than $3 million.
Chambi has won far more cases than he has lost: He won jury verdicts in seven of the nine cases that went to trial, including one earlier last month. Nineteen cases were dismissed. Three are pending.
The Register revealed that Chambi lost his post as a medical professor at the University of California, Irvine, in 1995 after allegations of incompetence and poor judgment, and that Western Medical later named him chief of neurosurgery and generated hundreds of thousands of dollars in patient revenues from his practice.
Western Medical defended Chambi in May. But by midyear it had hired a San Francisco neurosurgeon to review his cases, interviews show, and by September the hospital's Medical Executive Committee had voted to suspend his privileges. Hospital officials declined to reveal the specifics of their findings but said doctors disciplined in such cases seldom return to their old practice.
One week later, Chambi voluntarily surrendered most of his privileges at a Fullerton hospital, St. Jude Medical Center, while that hospital investigates.
Since May, more than 120 patients or their family members have contacted the Register to talk about Chambi.
Eighteen of the patients defended Chambi's skills and compassion. More than 100 expressed concerns about the treatment they or a loved one had received -- or criticized hospitals and state regulators for not doing more to warn about Chambi's history.
The Medical Board of California's Web site offers a feature allowing patients to "Check your doctor online.'' But the site does not show that Chambi has been suspended by Western Medical Center. In fact, under "Hospital Disciplinary Actions'' it says "No records returned.''
Patients such as Guy and Linda Arnold of Phoenix question why the Medical Board is not disclosing Chambi's history. Guy Arnold canceled back surgery with Chambi after Linda Arnold's mother searched Register newspaper clippings in a local library and found details of the doctor's history.
"Someone that's had this many problems, there should be a disclosure from the Medical Board,'' Linda Arnold said.
Medical Board officials say state law does not require them to report a doctor's suspension. Under state law, the board is required only to report to the public hospital disciplinary actions that result in termination or revocation of a doctor's privileges.
"The board staff is trying to be consistent in legally reporting what we are allowed to report,'' said Joan Jerzak, chief of enforcement for the board.
Jamie Court, a Santa Monica consumer advocate who specializes in health-care issues, called the Medical Board's interpretation of state law "outrageous.'' Court said the doctor-controlled Medical Board tries too hard to interpret the rules to the benefit of doctors.
"This is not a proactive board. Their interpretation of the rules is compromised,'' said Court, who is executive director of the Foundation for Taxpayer and Consumer Rights.
"It's really frightening that the public isn't being protected. If a hospital goes to the extraordinary step of taking a doctor's privileges, the public should know,'' he said.
Two years ago the Register examined the Medical Board's handling of complaints against 200 local physicians and found that the board rarely investigates and that it responds slowly and gives lenient penalties.
Medical Board officials say they are working hard to respond more quickly and efficiently to complaints. But they say their job has been made more difficult by new laws that complicate the process, by budget cuts that took 15 investigators, and by backlogs in administrative court that delay hearings for at least a year.
Jerzak, who took over as chief of enforcement in June, said the average complaint against a doctor is investigated and disposed of in six months.
But if there are multiple complaints against a physician or if investigators are trying to document a pattern of negligence, the case can take months longer. If the Medical Board files charges and the doctor insists on an administrative hearing, the process will take at least another year to play out.
"The fact that a disciplinary case may take as long as it does to get through the process -- it's a horrible delay,'' said Jerzak.
But Jerzak said many delays are unavoidable: Investigators must track original medical records -- sometimes resorting to subpoenas when people won't cooperate. Witnesses and the accused doctor must be interviewed. And the case must be sent to an objective medical expert for review.
Jerzak added that the law requires the Medical Board to meet a high standard: clear and convincing evidence of gross negligence, of incompetence or of a pattern of simple negligence.
"It would surprise your readers that if a doctor amputates the wrong leg, that is construed as simple negligence,'' she said. In other words -- if that case stood alone, the doctor probably would not be subject to discipline.
"We are not driven by the medical outcome,'' Jerzak said. "We are driven by the standards in the medical community.''
Zuk, Chambi's attorney, said the doctor believes the Medical Board will eventually resolve the complaints in his favor, and that he hopes to win back his privileges at Western Medical Center. Zuk noted that a Superior Court jury recently found that Chambi was not negligent in the case of a Temecula woman who experienced serious complications after neck surgery.
"He feels that he will be vindicated,'' Zuk said. "The fact that a jury in an open court found for him on the (Diane) LaLonde case is a good thing, and it might just embarrass certain people in this town.''
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