Stepped In It by Pat Conrad MD


Looks like we can file this one under “Oops”…or aw sh….

A Fairfax County, Virginia jury ordered a local anesthesiologist and her practice to pay $500,000 to a patient for defamation and medical malpractice. While being prepped for his colonoscopy, “the plaintiff apparently told the anesthesiologist that he had passed out previously while having blood drawn and that he was taking medication for a mild rash on his genitals.” Fearing that he would be too doped to remember the doctor’s instructions following his April, 2013 colonoscopy, the plaintiff pushed “record” on his smartphone mic to get the post-procedure instructions. “The man’s phone, in his pants, was placed beneath him under the operating table and inadvertently recorded the audio of the entire procedure, court records show.” And when he got home, the man got to hear all of the nasty OR banter:
– “After five minutes of talking to you in pre-op,” the anesthesiologist Tiffany M. Ingham, MD told the sedated patient, “I wanted to punch you in the face and man you up a little bit.”
– The recording captured Ingham mocking the amount of anesthetic needed to sedate the man.

– In referring to a rash on the man’s penis, Ingham was recorded warning a medical assistant not to touch it, “saying she might get “some syphilis on your arm or something,” then added, “It’s probably tuberculosis in the penis, so you’ll be all right.””

– The doctors then discussed “misleading and avoiding” the man after he awoke, and Soloman Shah, the gastroenterologist, reportedly told an assistant to convince the patient that “he had spoken with Shah and “you just don’t remember it.” Ingham suggested Shah receive an urgent “fake page” and said, “I’ve done the fake page before,” the complaint states. “Round and round we go. Wheel of annoying patients we go. Where it’ll land, nobody knows,” Ingham reportedly said.”
– ” Court documents state Shah also made some insulting remarks — “As long as it’s not Ebola, you’re okay.” (Insulting?).

– “Ingham then mocked the man for attending Mary Washington College, once an all-women’s school, and wondered aloud whether her patient was gay, the suit states.”
– “The anesthesiologist said, “I’m going to mark ‘hemorrhoids’ even though we don’t see them and probably won’t,” and did write a diagnosis of hemorrhoids on the man’s chart, which the lawsuit said was a falsification of medical records.”

– After declaring the patient a “big wimp,” Ingham reportedly said: “People are into their medical problems. They need to have medical problems.” Shah replied, “I call it the Northern Virginia syndrome,” according to the suit.

The doctors’ attorneys argued that the recording was illegal, but the man’s attorneys noted that Virginia is a “one-party consent” state, meaning only one person involved in a conversation need agree to the recording. The doctors argued that the patient did not suffer any physical injury or miss any days of work. The plaintiff complained that he was “verbally brutalized” and suffered anxiety, embarrassment and loss of sleep for several months.
The anesthesiologist has since moved to Florida; the gastroenterologist was dropped from the case.
One of the jurors commenting on the requested $1.75 million judgment, said that the $500,000 award was a compromise because “we have to give him something, just to make sure that this doesn’t happen again.”
“These types of conversations,” testified Kathryn E. McGoldrick, former president of the Academy of Anesthesiology, “are not only offensive but frankly stupid because we can never be certain that our patients are asleep and wouldn’t have recall.”
A few observations:
– Dr. McGoldrick is of course correct, and – let’s be honest – we all know she is protecting the party line.

– The docs in this case were over the line and neither shall I defend their stupidity. But…

– Let’s not get on our high horse: Physicians should not say many of the off-color things that they routinely say in the OR. And the first one of you, who actually completed a residency, who claims you never heard or said such, and never thought it was funny, is a damn liar.

– What kind of patient records the audio of his entire colonoscopy? This smells. I’m not sure how thorough the colonoscopy prep was, because my gut tells me this plaintiff is full of used groceries.

– It is often a sad truth in medicine that speaking the truth is NOT the way to go. The truth is that North Virginia Syndrome is a very real and prevalent neurosis among the tight-twisted pretension addicts in that region. And up until 1970, Mary Washington was an all-girls school. I’d have made fun of that too.

– Doctors steel themselves, along with the traditional methods of dissociation, denial, rage, and alcohol, with coarse humor to laugh at the fallibilities in others, and often pray not to find at some point those same failings in themselves. For all the stupid TV dramas about medicine, patients don’t want to know what it’s really like, and they raise hell when they find out.

– Doctors can be dicks.

– So can patients.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  8 comments for “Stepped In It by Pat Conrad MD

  1. violet
    July 2, 2015 at 5:50 pm

    some patients are out to get the quick buck and will take you down if they have the chance….NEVER give it to them…….

  2. Hawgguy
    July 1, 2015 at 3:54 pm

    I must be out of the norm. In nearly 30 years of practice, both in and out of ORs I have not witnessed nor participated in this type of behavior. Both the Anesthesiologist and the GI sound like unkind, insensitive doctors.

  3. Alan
    July 1, 2015 at 8:25 am

    The plaintiff is a lawyer so, by definition, he is a douche!!!!!!!!!!

  4. Bill Ameen MD
    June 26, 2015 at 9:56 am

    The first thing I wondered was how did they allow his cell phone in an OR?? Reminds me of an old saying, “If it CAN happen, it WILL happen.” That said, we’re not human if we don’t have some reaction to our patients’ anxieties and strange stories. When I was in practice and somebody had told me something really bizarre, it was hard not to share it with my most loyal staff when the patient had left the building. It’s funny, I really don’t remember any snarky comments from staff during my training in the OR 40 years ago. All I recall was how desperate I was to hold the retractors in the right position!

    • Sir Lance-a-Lot
      June 26, 2015 at 10:16 am

      “… how did they allow his cell phone in an OR??”

      It wasn’t an OR. It was an outpt endoscopy suite, I believe in a private freestanding medical building.

      He put the phone in his pants pocket, then he took off his pants, and they staff put them under the stretcher.
      Dumb oversight on their part, but I guess not something they would have thought of.
      We’ll all think of it now.

  5. Sir Lance-a-lot
    June 26, 2015 at 6:45 am

    I’ve not only heard conversations like this, but participated in them.

    I probably say something like at least part of what’s on that tape every single day, and I would have real problems trusting any doctor who claimed he didn’t.

    Whether it’s “Northern Virginia Syndrome” or “Boston Suburb Syndrome” or “Upper East Side Syndrome,” it’s all the same disease, it’s annoying as hell, it makes ME want to punch them, and the truth of that is borne out by the fact that this loser sued them, rather than call the office manager and get the doc to apologize.

    And as far as “one-party-recording” states – that’s a law that says that it’s okay to record a conversation IN WHICH YOU ARE PARTICIPATING, as it is the same thing, effectively, as taking notes. In this case, the pt. WAS NOT participating in the conversation, and had no expectation of participating, as he was UNDER ANESTHESIA. I suspect they will win on appeal, and that their victory will not be noted in the press, as it will not be a “bad doctor” story.

    Moral of the story: Never trust a patient, especially an overprivileged dipshit who tells you he passes out when he sees himself get an IV, all the while watching as you start his IV.

    • Sir Lance-a-lot
      June 26, 2015 at 7:33 am

      I will add that the OTHER reason why they will win on appeal is that the slander statute requires not only that Person A say something that is BOTH untrue and potentially damaging regarding Person B, but that there be a Person C to whom this is being said, who ACTUALLY BELIEVES it.

      I guarantee you that nobody in that room believed that this guy had syphilis, or penile tuberculosis, or Ebola (I suspect they all believed he was a douche, but that was apparently self evident), so the entire basis of the jury’s finding is flawed.

    • Pat
      June 26, 2015 at 3:57 pm

      These and below were well said, Lance!

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