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A Trail Of Death And Gruesome Injuries
Glenn O'Loughlin will spend the rest of his life taking things slowly.
A surgical error made 13 years ago by Dr. Jose Nabut of Florida cost O'Loughlin 17 feet of his intestine. Now his routine includes methodically counting out the 40 prescription pills he swallows every day to help digest his carefully chosen meals. If he accidentally eats the wrong thing - anything fried, for example, or fresh vegetables - he'll be doubled over in pain.
Nabut, by contrast, has always been a man in a hurry. After only two years of college he took off for the Autonomous University of Guadalajara medical school, where an undergraduate degree is not required. Years later, he learned a new surgical technique - the one he would use on O'Loughlin - at a weekend seminar, where each doctor got to practice once, on a pig.
O'Loughlin's lawyer discovered these details of Nabut's training during malpractice proceedings, long after the damage to O'Loughlin had been done.
"If I had known any of that, I never would have gone to him," O'Loughlin said. "But when your insurance company refers you to a doctor, you just trust that they know what they're doing."
Nabut was accused of injuring at least four patients after returning from that seminar, according to plaintiffs' lawyers. A string of legal judgments divided $15 million in malpractice payments among the victims.
Nabut declined to comment.
O'Loughlin's painful saga started when Nabut mistakenly stapled shut his bile duct during what should have been a routine outpatient gallbladder removal. After eight surgeries trying to uncrimp the damaged tissue, O'Loughlin's torso is a patchwork of long, deep scars.
"The ones that aren't straight are Nabut's," O'Loughlin said while lifting his shirt.
At one point in his long road to recovery, a massive section of O'Loughlin's intestines ruptured, spilling their infected contents into his thoracic cavity. Every important system in his body began to shut down. O'Loughlin remembers hearing a nurse in the emergency room shout "We're losing him!" just before his heart stopped briefly during the rush to get him into the operating room.
But O'Loughlin, who recently was laid off from his job as computer project manager, said he hasn't seen a penny of the $10 million a court ordered Nabut to pay. That's because Nabut was practicing without malpractice insurance.
Anyone looking at the record of Dr. Anacleto Capua might wonder where he learned to be a doctor.
That thought clearly crossed a few minds at the Florida medical board. They twice told Capua to take refresher medical courses after he failed to diagnose fatal conditions in patients he saw in an emergency room.
The first time regulators ordered the Manila Central University-trained doctor to hit the books was after Capua dismissed the concerns of 31-year-old Robert E. Love, who showed up in the emergency room complaining of severe chest pain. Capua examined him, concluded he'd be OK with a little rest, and sent him home. Love died of a heart attack later that night.
The second time was after Capua failed to recognize the grave danger facing a patient who had an orange-size aneurysm threatening to rupture a major blood vessel in his stomach. Instead of calling a surgeon to examine the patient, Capua sent him home with a painkiller that other doctors said was a bad choice for a patient at risk of abdominal bleeding.
When the man returned to the emergency room in severe pain a few hours later, Capua prescribed another questionable drug, one that affects blood pressure and could be "disastrous" for a patient with a bulging aneurysm, the medical board concluded.
An hour after that, another doctor took a quick look at the patient, examined the same X-rays Capua saw, and immediately realized that the man's life was hanging by a thread, medical board records show. He ordered emergency surgery, but it was already too late. The aneurysm burst and the patient died before the operation began.
On yet another occasion, Capua was sued for failing to diagnose a potentially treatable case of meningitis in an infant who later died from complications of the disease.
Capua did not return repeated telephone calls.
A Dozen Complaints
Guadalajara graduate Brent E. Woodfield got in trouble for performing operations the Idaho State Board of Medicine claimed his patients didn't need. Worse, fellow doctors said he was a clumsy surgeon who couldn't distinguish one part of the human body from another.
The Idaho board reviewed complaints involving 12 women treated by Woodfield at his practice in Rexburg, Idaho, in the early 1990s. The panel of doctors concluded that Woodfield didn't seem to understand "the basic principles of the practice of medicine."
The board found that six surgeries were done so incompetently they put the patients at undue risk, and three were determined to be unnecessary. One of those involved a complete hysterectomy. It was not clear whether Woodfield explained to the woman that she would never be able to have children afterward.
In another case, a fellow surgeon said he got worried when Woodfield inserted a knife too deeply into the patient's abdomen, which risked slicing through the woman's healthy internal organs. Woodfield also confused a normal part of the woman's backbone, known as the sacral promontory, for a potential tumor. The assistant surgeon and the anesthesiologist had a hard time talking Woodfield out of performing a biopsy on the healthy bone, according to the medical board report.
On yet another occasion, Woodfield failed to make sure that he had enough blood on hand before performing an operation on a woman who was hemorrhaging dangerously after childbirth. An anesthesiologist noticed Woodfield's oversight and ordered the extra blood himself. But doctors investigating the incident were disturbed by their conclusion that Woodfield deliberately "misstated" the amount of blood the patient lost during the operation.
The final straw, however, was an affair Woodfield allegedly had with one of his patients. The panel called the sexual trysts a "gross ethical violation."
Woodfield, who now drives a truck on Cape Cod, declined to be interviewed. His wife, Lisa, said he denies the board's allegations and is pursuing legal action to have his license reinstated.
She said that Woodfield's problems in Idaho were largely political and that her husband is a victim of his own brilliance.
"Sometimes he just knew things, but he couldn't explain how he knew them," she said in a recent interview. "Brent is a brilliant clinician. He's very intuitive. I think some of the other doctors were a little intimidated by that."
Stacy Ruckman was 23 years old and had just landed a new job in February 1988 when she went to the Central Healthcare Clinic for Women in Springfield, Mo., for an abortion. She didn't tell her parents where she was going that afternoon.
"Stacy's the type that would always try and take care of her own problems," her mother, Judith Ruckman, said.
Dr. Scott R. Barrett Jr., listed by the AMA as a graduate of Howard University Medical School, began the abortion at about 5 p.m., and 30 minutes later all appeared to be going well. But at 6 p.m., as Ruckman tried to climb off the operating table, she went into a seizure, according to a detailed report on the incident filed by state regulators.
A minute passed, and Ruckman stopped breathing. Barrett couldn't get a pulse. An ambulance was called to the clinic.
The paramedics worked furiously on the young woman, suctioning clotted blood from her throat and repeatedly delivering electric shocks to her chest in an effort to restart her heart. They eventually succeeded, but it was too late. By the time Ruckman's heart was beating again, she was brain dead.
An investigation concluded that Barrett was involved in a series of errors that began when he administered a powerful anesthetic to Ruckman too quickly. State regulators found that despite the well-known dangers associated with using the anesthetic, Barrett failed to keep adequate monitoring and rescue apparatus handy, and he mismanaged efforts to revive her.
That wasn't Barrett's only problem abortion.
A month earlier, an 18-year-old woman had been rushed to the hospital in shock after Barrett performed an abortion on her. According to Missouri regulators, doctors at the hospital found a 2- to 3-inch tear on the woman's uterus and said that she had lost two-thirds of her blood.
In yet another case, a 20-year-old abortion patient awoke from her procedure drenched in blood. After slipping in and out of consciousness, the woman came to again to find Barrett carrying her to her own four-door Chevrolet Caprice. A friend drove her to the hospital emergency room.
In 1992, The Missouri Board of Healing Arts revoked Barrett's license for "gross and repeated negligence." Barrett could not be reached for comment.
Stacy Ruckman's mother, Judith Ruckman, said she is still haunted by the memory of the night she and her husband raced to the hospital to find their daughter, her heart beating but her brain completely gone. She died soon after.
"That night when we walked out of the hospital I just felt like I left part of me in there. Part of me was dead," Ruckman said. "You carry a child for nine months and something like that happens, you feel like you lost part of yourself, part of your body. And you're never going to get it back."
A Missing Spleen
Paintsville is a poor town in the heart of Kentucky coal country, and for many years when people got sick they'd go to Dr. Robert Hall for help.
So when Hall got sick and had to retire, it was only natural for his patients to turn to the man brought in to replace him: Dr. Kenneth LeRoy Jones. What they didn't know was that Jones, a 1978 graduate of Howard, had left Baltimore in the wake of the scrutiny of medical regulators, who had accused him of questionable prescription practices involving powerful painkillers.
Jones, in a legal deposition, said his dispute with regulators involved people who were writing prescriptions in his name.
But Jones did not leave his troubles behind him when he arrived in Paintsville.
Sandra Fletcher was one of the patients who turned to Jones for care after Hall retired. Jones, she said, recommended an operation on her esophagus to relieve the pain from intestinal problems. But, according to a lawsuit she later filed, during the surgery Jones lacerated her liver and unexpectedly removed her spleen.
"I don't know if it was a day after, two days after, the nurse came in and said: `You are going to have to be real careful,'" Fletcher recalled. "I said, `Why?' She said, `The doctor removed your spleen.'"
"I said, `What?' She said I started hemorrhaging and he had to remove the spleen."
Fletcher's tale was just one of many frightening stories told in lawsuits and regulatory reports that would mark Jones' tenure in Paintsville. Between 1996 and 1999, 11 malpractice lawsuits were filed against Jones, with some also naming the hospital where he worked.
A complaint filed against Jones by Kentucky regulators said that his hospital privileges were not renewed for "unintentionally lacerating organs during surgery" and found that two hospital admissions Jones was involved in resulted in deaths due to "acts of omission or commission."
The board revoked Jones' license in 1999. Officials at the hospital did not return telephone calls; Jones could not be reached for comment, although in legal filings he denied the allegations made against him.
Among those who sued was the family of Jackie Risner, who was rushed to the hospital's emergency room after a coal truck flipped over onto his car in April 1995. Jones was the surgeon on call that night and family members said they had been told that because Risner's injuries had been so severe, he'd been forced to remove his spleen.
Several months later, as Risner was recovering, he asked Jones if he should be given preventive vaccines to guard against infections, which are more likely in people without spleens. But Jones, according to a lawsuit, said the shots were not needed. In a deposition, Jones said he told Risner it was up to him whether to get the vaccine and would have given it to him had he wanted it.
On April 27, 1996, Jackie Risner died from bacterial infection, the lawsuit says.
"We never did get over it, we're not over it yet, losing our oldest son," said Geraldine Risner, his mother. "We've got two more sons, but that don't make up for the one we lost."