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Surgical mishap illustrates the importance of due diligence

Credentialing Resource Center Connection, July 1, 2003

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Dear Credentialing Colleague:

Once again, credentialing is in the news--this time in the state of Hawaii. The Associated Press recently reported that a surgeon chose to implant the shaft of a screwdriver into a patient's spine when he could not locate the proper titanium stabilization device. If this story is true, it would suggest a terrible lapse of judgment on the part of the surgeon, but would not suggest a problem with the hospital's credentialing process. Hospitals cannot be expected to be clairvoyant and anticipate such isolated incidents.

If, however, the hospital knew of problems in the physician's past and failed to consider them, or if the hospital hadn't conducted thorough primary-source verification, it should seek to improve its processes.

What could the hospital in Hawaii have known about this surgeon? The incident occurred on January 29, 2001, so we conducted a simple background check using the Fraud Abuse Control Information Service (FACIS) operated by Government Management Services, Inc. ( www.facis.com ) to determine what the facility might have known about the alleged implement improviser.

According to FACIS, they might have found that the Oklahoma State Board of Medical Licensure and Supervision suspended his license and issued a five-year probation in January 1999. They also might have found a licensure revocation from the Texas State Board of Medical Examiners in April 2000, as well as two Office of Inspector General exclusions (one in 1994, the second in 1996). Timing may not have allowed them to know about the final negative action taken by the Kansas State Medical Board of Healing Arts in 2002.

Clearly, due diligence would have disclosed this surgeon's questionable past. One can only wonder what action a diligent credentials committee would recommend when faced with an application from a physician with such a record. I know that most of you would collect far more information before recommending a physician to the board of directors. In fact, it is highly unlikely that many readers would even consider permitting such an applicant to set foot into their operating rooms.

Due diligence pays off.

That's all for this week.

All the best,

Hugh Greeley

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