Beleaguered Surgeon Continues to Find Work in California

After office hours one Friday, Denver neurosurgeon Kenneth P. Burres piled his examination table, waiting room furniture and some medical records onto a truck and set out for California--abandoning his practice.

It was 1987, and he was fleeing a host of problems: a medical board investigation of malpractice suits against him, and financial and marital woes. He slipped out of town without warning his physician partner, his staff or his patients, according to Colorado medical board records.

Citing “patient abandonment” and his refusal to complete a state-ordered psychological exam, Colorado medical regulators revoked Burres’ medical license in 1989.

And although he had left the state, the Colorado board subsequently leveled six accusations of substandard care against him involving patients he had treated in the early 1980s.

In 1990, two of the cases were upheld. In one, Burres was accused of performing back surgery with insufficient medical justification. In the other, he was found to have operated on the wrong spinal disc.

Years later, Colorado officials say the Burres case sticks in their mind as an especially troubling incident of physician negligence.

“This guy abandoned his practice, left Colorado and, despite that, we took another shot at him,” said Bill Higgins, a Colorado assistant attorney general.

But that was Colorado. This is California, where Burres now works as a surgeon at Columbia Chino Valley Medical Center in Montclair. The center is owned by Columbia/HCA Healthcare, the nation’s biggest hospital chain.

Indeed, despite his Colorado troubles, Burres has found work repeatedly in California. Two weeks after abandoning his practice, the Stanford-trained Burres started work at a Kaiser Permanente hospital in Fontana and stayed until 1989.

Burres left when word of the Colorado “patient abandonment” reached California regulators and Kaiser began its own inquiry.

Before the year was out, Doctors Hospital of Montclair--then owned by National Medical Enterprises, a hospital chain known for aggressive recruiting of physicians--lured Burres with a lucrative financial package.

He was guaranteed nearly $350,000 a year, including a $96,000 “directorship fee,” and other perks, according to hospital documents provided to The Times.

California regulators did intervene in 1990, technically revoking Burres’ medical license on the basis of the abandonment, but then suspending the action. He was placed on five years’ probation.

By the early 1990s, Burres’ medical practice earnings topped $700,000 a year, according to court records in his 1993 divorce.

And in 1994, California lifted Burres’ probation--18 months ahead of schedule.

By then, Burres had linked up with Larrian Gillespie, a Beverly Hills urologist who had started the Pelvic Pain Treatment Center at the obscure Montclair hospital.

Burres’ surgery on Gillespie’s patients led to about a dozen malpractice claims against the two doctors and the hospital. Gillespie recently settled with 10 patients.

Burres declined all comment. His lawyer, Brian Depew of Los Angeles, strongly disputed the patients’ contentions of medical wrongdoing.

The Burres case lifts the veil on what seemed a casual and passive approach--by California regulators, hospital administrators and physicians’ peers--toward monitoring the behavior of doctors. The approach may be reflected in the explanation by Dr. Stanley Saul, a former head of surgery at the Montclair hospital, of the decision to hire Burres.

“It was a close call,” Saul recalled, noting that hospital officials were aware that Burres had abandoned his practice. “The feeling was, if he’s a bad surgeon, we’ll pick him up in quality assurance . . . and we’ll take away his privileges then.” Saul added that the hospital administration was “pushing big time” for him to be hired.

The hospital chose Burres despite the fact that, according to the American Medical Assn., fewer than 1% of U.S. doctors face medical license disciplinary actions during their careers.

To land his first California job, Burres had planned ahead: He was hired 11 days before he abandoned his practice, said Kaiser spokeswoman Kathleen Barco. “It looks like he slipped through the cracks,” she said.

Larry Sharfstein, a Kaiser manager who oversaw Burres’ job application, said: “Had we known most of this information, I find it hard to believe he would have been offered a position.”

At the time Burres was hired in Montclair, Colorado had not yet taken its second disciplinary action against him. All the Montclair hospital knew was that Burres had walked away from his practice, citing personal and financial woes.

Colorado regulators said they considered Burres’ actions more than just those of an emotionally distressed doctor.

“If a physician abandons his patients the way Dr. Burres did, then we would have other concerns about how he practices medicine,” said Susan Miller, the Colorado board’s administrator.

California classifies patient abandonment as “unprofessional conduct” but not necessarily an issue of poor patient care--and less serious in nature, said Candis Cohen, a spokeswoman for the California Medical Board.

Cohen noted that legal standards for proving medical negligence differ among states, explaining why one state’s actions may be tougher than another’s.

In 1994, the California board agreed to lift his probation and reinstate his license more than 18 months early. Humberto Flores, an administrative law judge, concluded that Burres’ “competency as a neurosurgeon has never been questioned” and that “the public would in no way be harmed if probation is terminated.”

Cohen said state records indicate that the board was unaware of the more serious Colorado finding of substandard patient care. But Colorado officials say their records show the case was reported in 1991 to both the Federation of State Medical Boards and the National Practitioner Data Bank.

“California should be embarrassed to death that they reinstated his license,” said Hunter Allen, an Atlanta attorney representing 10 former patients of Burres and Gillespie in a malpractice action.

Officials of Tenet Healthcare (formerly called National Medical Enterprises), the hospital company that owned Doctors Hospital of Montclair when Burres was hired, declined to comment. Tenet sold the Montclair hospital, now called U.S. Family Healthcare Medical Center, in 1994.

Less than a year ago, Burres found work at Columbia Chino Valley Medical Center, where he continues to perform surgery.

Anthony Armada, chief executive of the Chino hospital, said he hadn’t known of Burres’ licensing problems.