28-Day Suspension of Surgeon Questioned

Concerned that the punishment may have been too light, Health Services Director Mark Finucane said Thursday that he has begun an investigation into why a County-USC Medical Center surgeon was suspended for only 28 days after allowing a “scrub technician” to operate on a patient.

Finucane also said he has begun looking into whether County-USC administrators notified the California Medical Board of the incident as required by law. On Wednesday, Los Angeles City Atty. James K. Hahn charged the hospital, Dr. Armineh Tavitian and surgical technician David Wengert with criminal misdemeanor violations in connection with the March 30, 1995, incident.

Dr. Ronald Kaufman, the hospital’s chief of staff, has defended the 28-day suspension of Tavitian. The suspension, Kaufman said, was fair because of mitigating circumstances that he would not disclose.

Although Kaufman said the hospital notified state medical authorities, Hahn said no such notification took place.

The state Medical Board investigator handling the case, Marc Posalski, confirmed that the state is also investigating the incident, but had no further comment.

Finucane, who took over the beleaguered county health department in January, said he has a number of questions about the case, particularly why the punishment was limited to such a short period.

“I’ve begun to question some of the [hospital] principals about what happened and how the disciplinary actions were decided--the 28 days as opposed to dismissal,” Finucane said in an interview. “I’m trying to figure out why 28 days were settled on and what were the extenuating circumstances that existed that didn’t result in anything more than that.” Tavitian, who has not returned calls seeking comment, no longer works for the county and has a private practice in Glendale. Prosecutors said Wengert still works for the county, but he could not be reached for comment.

Any suspension of a doctor for more than one month must be reported to the National Practitioner Data Board, according to Dr. Sidney Wolfe, head of the health research arm of Public Citizen, a consumer rights organization founded by Ralph Nader and based in Washington.

Such information is made available to hospitals and other medical institutions. If a physician is suspended for less than one month, the suspension will not show up in any central database and other hospitals will have no way of knowing it occurred, he said. “Systems need to be in place to prevent these kinds of incidents,” Wolfe said. “Doctors are not alone in the operating room, other people are there. The second something happens, someone should report it.

“We only get a very small glimpse of these incidents,” he concluded, “because institutions do not want us to find out about them.”

Supervisor Gloria Molina, who represents the district that includes the hospital, said she was outraged that the doctor wasn’t fired over the incident. She said she has directed her staff to begin an investigation into this incident and why so few doctors working for the county are punished severely for violations.

“I think this person should have lost their job,” Molina said. “[The patient] was in for elective surgery. She got scheduled, she got prepped, and what, the doctor took a hike? Did she go get a cup of coffee?”

Molina said she especially wants to know why a 28-day suspension was meted out instead of 30 days or more, and who made that decision. “Was it for a strategic purpose?” she asked. “Or again, do we have that coziness among doctors issue?”

“They are all pals,” Molina said of the county’s doctors. “They have colleagues investigating each other. When an incident occurs, it is the same doctors within the same unit that conduct the investigation. And we don’t hold them accountable.”

Tavitian, who prosecutors said also goes by the last name of Aghajanian, was a senior surgical resident at the Women’s and Children’s Hospital at County-USC when the 23-year-old woman came in for surgery under anesthesia.

Citing a medical board investigation, Hahn alleges that Tavitian left the surgery room and entrusted the surgery to a medical intern and Wengert, even though his duties are usually limited to counting and sterilizing surgical equipment.

Wengert, Hahn said, made an incision into the patient, cut one of her Fallopian tubes and cauterized it. The intern, who was not charged, cut the other tube, Hahn said. The woman apparently was not harmed by the surgery.

Tavitian and Wengert face up to six months in jail and a $1,000 fine for practicing medicine without a license, and up to a year in jail and a $1,000 fine for practicing without a license under conditions creating risks of great bodily harm. In addition, they face up to six months in jail and a $2,000 fine for battery. The medical center faces as much as $11,200 in fines.

Hahn said prosecutors were only notified after Molina’s office received a tip about the procedure and forwarded it to authorities.

The arraignment of Tavitian and Wengert is set for April 17 in Los Angeles Municipal Court, and the medical center’s arraignment is set for April 24.

Times medical writer Thomas H. Maugh II contributed to this story.