A former pathologist at Martin Luther King Jr./Drew Medical Center acknowledged this week that he misdiagnosed a few patients at the troubled public hospital but said his colleagues and the hospital’s faulty systems set him up for failure.
The Medical Board of California had accused Dr. Dennis G. Hooper of negligence in six cases. In some, the board said, he failed to detect cancer in patients who had it. In others, he diagnosed the disease in patients who did not have it, including a woman whose reproductive organs were removed after Hooper wrongly diagnosed her as having uterine cancer.
Hooper’s trail of alleged misdiagnoses was detailed in a Times story in December.
At his hearing this week before an administrative law judge, Hooper said he consistently sought help to interpret patient slides at King/Drew in 2000 and 2001 but rarely received it. He lamented the quality of the microscope he was given, called his office a “dungeon,” criticized rules imposed by his superiors and faulted the speed at which dictated pathology reports were transcribed.
During the four-day hearing, which concluded Thursday, experts for both the state and Hooper’s defense separately testified that his work fell below the acceptable standard of care in at least three patient cases.
Hooper’s expert said he should be required to seek additional training and prove that he is competent in surgical pathology.
Deputy Atty. Gen. Ismael Castro asked the court to revoke Hooper’s license to practice medicine in the state.
“What this court heard from the very beginning were a variety of explanations, a variety of excuses by Dr. Hooper,” Castro said in his closing argument.
“All he sees is the problems that are around him and makes excuses for not complying or not meeting the standards, and I find that appalling.”
During his testimony, Hooper said he had tried to work within a hospital that had no quality controls.
“I don’t think I’m a bad pathologist,” he said. “I don’t think I’m a bad M.D. I follow up with patients. I care about patients.”
When administrative law judge Samuel D. Reyes issues his opinion, the medical board will make the final decision to accept, reject or change it. Physicians can then appeal in Superior Court.
During the course of the hearing, patients were referred to by first name and last initial. The Times has independently identified them.
Among the cases cited by the board was that of Johnnie Mae Williams, who went to King/Drew in March 2001 for a seemingly minor gynecological exam. Hooper diagnosed her as having cancer of the uterine lining, and surgeons removed her reproductive organs, according to her medical records.
Records later showed that his findings were based on a slide from another patient, who had brain cancer. In his report, Hooper raised the possibility that the slide had been mislabeled, but the medical board said he did not investigate further.
Dr. Lowell Rogers, a Long Beach pathologist and the state’s expert witness, said the misdiagnosis should have been “quite obvious for a variety of reasons.”
“When there’s a slide that’s missing or an extra slide, you have to resolve those conflicts,” Rogers said. “She was diagnosed with cancer when she didn’t have it.”
Hooper said he had tried to investigate the problem by showing the case to his department chairwoman and sending the case out to a private laboratory for review. Both also got the diagnosis wrong, he said. And Hooper said he warned Williams’ treating doctor about the potential problem, but that doctor proceeded with the surgery anyway.
“He was going to do the surgery whether or not my report came back as malignant or not malignant,” Hooper said. “He knew I had sent it out, and the results weren’t back yet.”
Williams has told The Times that no one from the hospital ever told her that she was cancer-free. She did not learn of the misdiagnosis until more than two years later, when a Times reporter -- unaware that she didn’t know -- sought her out for an interview.
Hooper said he had sought permission to tell Williams about the error, but his request was denied by the hospital’s risk management department.
The medical board also alleged that Hooper missed prostate cancer in a 58-year-old man, did not catch bladder cancer in a 75-year-old woman and failed to spot leukemia in a 27-year-old man, among other cases.
Hooper generally defended his actions but did acknowledge making mistakes in the case of the 75-year-old woman, Virginia Jackson. In July 2000, he failed to spot malignant cells in her urine. Six weeks later, another pathologist found invasive bladder cancer in a biopsy, records show.
“I can try to think of every excuse in the book,” he said. “I didn’t have a good microscope. I was busy.... The problem is that I missed it, and I admit to that, and that is something that is a problem.”
Still, Hooper faulted King/Drew for not having staff members to assist with the review of urine cells.
Hooper stopped reviewing slides at King/Drew in June 2001, when he went on disability leave. He remained an employee for another year.
He subsequently moved to Texas, working in east Texas and then San Antonio.
A week after the Times’ article on Hooper was published in December, he resigned as a pathologist at Baptist Medical Center in San Antonio.
Hooper’s lawyer, J. Grant Kennedy, said his client has suffered enough because of publicity. Kennedy said Hooper, at most, deserved a reprimand.
“Dr. Hooper is a good man. He did what he should do,” Kennedy said in his closing argument. “He just got in with the wrong company.
“That’s what happened.”