With more than 25 years of experience in academic orthopaedic surgery, Mitchel B. Harris, MD, has been named chief of the Department of Orthopaedics at Massachusetts General Hospital, effective October 1, 2017. Burke raised his concerns about overlapping surgery. MRI results came in after midnight and confirmed that something was very wrong. Dr. Elhassan spoke with WCVB about his innovative approach to restoring function and range-of-motion in a patient long-suffering from chronic shoulder pain. He is also the Chief of Orthopedics at Morton Hospital. In 2000, Dr. Freiberg joined MGH as Chief of the Adult Reconstructive Surgery Service. Burke could not get concerns about double-booking off his mind. But change came to his door. Bassem Elhassan MD, Co-Director - MGH Shoulder Service, Boston Shoulder Institute Fellowship Program Director, Professor of Orthopedic Surgery, Harvard Medical School Jon J.P. Warner MD, Co-Director - MGH Shoulder Service, Director Boston Shoulder Institute, Acting Chief, MGH Sports Medicine Service, Chair for Quality and Safety for Orthopedics, Professor of Orthopedic Surgery, Harvard . Our multi-disciplinary spine team uses non-operative therapies and advanced surgical techniques to treat all spine conditions and disorders. Orthopaedics Advances in Motion provides health care professionals with information about the latest innovations from Mass General. He also gave Burke a tour of MGHs cardiac care unit. Some doctors, Wood among them, consider disclosure of double-booking a case-by-case call. Shervin had herself tried and failed to put the hip back into place. Wood said he did nearly all of Mengs surgery himself and did not even scrub in for the second part of the other patients procedure, leaving it to the surgical fellow. Im very proud of my department and our surgeons and our care.. Partway through the procedure, Bhattacharyya left Shervin and another resident in room 21 and scrubbed into operating room 25 as the attending for an ankle fracture case that had started two minutes after Pereiras case, according to medical records. He had taken comfort, he said, knowing that her surgeon wasnt occupied with anyones care but hers. Is this how we are planning the future?. As chief, he was instrumental in the creation of the Orthopedic Research Laboratories. The three surgeries overlapped for a total of 13 minutes, records show. The Harvard Orthopaedic Journal is an annual publication of the Harvard Combined Orthopaedic Residency Program which includes Massachusetts General Hospital, The Children's Hospital, Beth Israel Deaconess Medical Center, and Brigham and Women's Hospital. Peter Dunn, M.D.,Richard M. Pino, M.D., Wilton Levine, M.D. What began as an internal discussion about safe surgical practice long ago turned personal and bitter, pitting top medical figures against one another. Is it right that their patients may have no idea? The fact that surgeons are allowed to run two rooms simultaneously is known by physicians, administrators, compliance officers, booking clerks, nurses, residents, and others, Burke wrote in March 2012 to Dr. Keith Lillemoe, head of surgery at MGH, in an e-mail obtained by the Globe. It had to be done, Burke told the Globe. He knew it was probably a breach of protocol, but he divulged his worries to Ronald Skates, a friend and former computer company executive. Rubash succeeded in boosting the volume of orthopedic surgeries by more than 20 percent and revenue by more than 48 percent between 1999 and 2003, according to the Harvard Business School case study. MD, co-chief of the Shoulder Service. RubashHarry E. Rubash, M.D.Chief of orthopedic surgery said in a recent interview that he never pressured his staff to do concurrent procedures. Our multi-disciplinary Spine team uses non-operative therapies and advanced surgical techniques to treat all spine conditions and disorders. Former US attorney Donald Sterns 2012 report remains private, its conclusions known only at the institutions highest levels. See video animations for common spine conditions and treatments. As a student at the University of Massachusetts Amherst, Burke said he had met with Austen one Saturday to discuss possibly transferring to the Massachusetts Institute of Technology, Austens alma mater. According to Kirk and Harry, Kirk has the fellow manpower to do this. For more information about these cookies and the data Previously, Dr. Harris served as the chief of the Orthopaedic Trauma Service at Brigham and Women's Hospital (BWH). Second, I will be involved in quality and safety evaluations and health hazard evaluation of medical devices, something I have done for many years outside of industry. I am absolutely thrilled for Dr. Freuberg on his new role. Learn about the many ways you can get involved and support Mass General. collected, please refer to our Privacy Policy. So he pressed ahead quickly with that phase of the surgery, completing, he said, all the major work before handing Meng over to a surgical resident, Dr. Rojeh Melikian, to close the skin on Mengs neck. Wood then went to the other operating room to make sure the surgical fellow had, according to Woods testimony, done the appropriate operation on the 70-year-old patient. After about 20 minutes, SkatesRonald SkatesTrustee of Mass. Even today, anesthesiologists complain about patients lying fallow under anesthesia while they wait for a surgeon busy elsewhere. From my understanding, the delay was not 2.5 hours. In medicine it is called concurrent surgery, and the practice is hardly unique to Wood or MGH. Please contact me if possible, to discuss your experience in this area, your research and results. The most extensive analysis of concurrent surgery was presented last year when a surgical resident at the University of Virginia Health System released a study not yet published that found no difference in short-term outcomes for patients and only minimal increases in surgery length when cardiothoracic surgeries overlapped by up to 45 minutes under closely monitored conditions. Dont lose hope, because we may have a solution, says Bassem Elhassan, MD, co-chief of the Shoulder Service. Raj Gala, M.D. Dr. Jay J. Patel brings his expertise to Hoag Orthopedic Institute as new Chief Strategy Officer. Then, moving to the other OR, Wood cut into Mengs neck to expose the spine for the procedure, known as a cervical corpectomy. She said she finally found the doctor in room 25 doing the ankle procedure and asked him to come assist Shervin. After a resident positioned her for the surgery, the attending surgeon, Dr. Timothy Bhattacharyya, made an incision to expose the hip, according to medical and court records reviewed by the Globe. At Lahey Hospital & Medical Center, you can trust our orthopedic surgeons to provide expert, personalized and compassionate care. I always felt like the [treatment] plan was built for me, and it was like a three-legged stool: It was an ongoing conversation between myself, the physical therapist and the doctor. Dr. Pedlow is a board-certified, fellowship-trained spine surgeon, specializing in the surgical treatment of disorders of the adult spine. We are committed to providing expert caresafely and effectively. (Lillemoe later said he had misspoken.). Our multi-disciplinary spine team uses non-operative therapies and advanced surgical techniques to treat all spine conditions and disorders. He was happy to put himself in the care of Wood, a doctor who was recruited by MGH as chief of its orthopedic spine service in 2004 and who would draw many plaudits from patients. Dr. Wood was listed as the attending surgeon for a second procedure at the same time he operated on former Red Sox pitcher Bobby Jenks. No one knows why it happened to Tony Meng, or how, or even exactly when. Dr. Bridwell is the Co-Director and Founder of the Pediatric/Adult Spinal Deformity Service. Hospital officials, in an interview, say Wood never left Jenkss room during the surgery. Dr. Kwon has varied clinical interests including sports-related injuries, arthritis, deformity correction, total ankle replacement, cartilage, ligament and tendon disorders and trauma. Warner, chief of MGHs shoulder service, earned just over $2.1 million between October 2005 and September 2006, making him the hospitals highest compensated employee at the time, according to financial documents filed by the hospital with the attorney general. Get more exclusive investigative journalism. Pereira struck the ground and felt a sharp pain on her left side. He is a member of the Department of Orthopedic Surgery at the Massachusetts General Hospital and New England Baptist Hospital, and an Associate Professor of Orthopaedic Surgery at . Now director of Orthopedic Trauma Services at Suburban Hospital in Bethesda, Md. He and I together recognized the need for new leadership to bring stronger management.. Search for condition information or for a specific treatment program. Double-booked surgery patients often didnt at the time, and sometimes still do not. Meng wouldnt know until long after he woke up in a recovery room following the 11-hour operation to hear a medical resident say, Mr. George J. Annas, a prominent patients rights advocate at Boston University, said its a no-brainer that a surgeon should inform a patient that the doctor intends to operate on that person and another patient in the same time frame. What will you tell this quadriplegic man and his family when they ask if his paralysis could have been prevented by having his surgeon be attentive only to him during his surgery? Burke wrote in an e-mail copied to senior leaders at MGH and Partners. In addition to his leadership role in trauma, he spent 14 years serving as an active member of the Orthopaedic Spine Service at BWH and initiated a weekly multidisciplinary spinal oncology meeting. By the time Bhattacharyya returned to implant the hip, they say, he had completed work on the critical parts of the ankle case, and the earlier operation in room 22 was also over. Chief of Partners Orthopedic Trauma Service, he was recruited in 1999 to develop a trauma program across the states largest health care network. So when he crossed paths with a trustee for the Massachusetts General Physicians Organization in early November 2010, the surgeon couldnt help himself. Nothing in the medical record indicates that Mengs sudden paralysis a known risk of the surgery had anything to do with Woods decision to juggle his care with another patients for about seven hours. There is no known connection between the complications and deaths and the double-booking, but none of the patients and family members interviewed had any idea that the surgeons were involved in a second operation at the same time. Dr. Joseph Schwab, Chief of the Orthopaedic Spine Center at Massachusetts General Hospital and Director of SORG, is featured in a new video from the Department of Orthopaedic Surgery at MGH. It was too late for a rapprochement. 5 Blossom St The Globe declined the hospitals request to return the documents for a review of Burkes redactions. General, where X-rays revealed she had fractured her left hip. Read the final policy. A 43-year-old former Anheuser-Busch sales manager from Peabody, Gregory has suffered from incontinence and sexual dysfunction since Dr. Wood performed spine surgery on him in October 2006. MGH officials say their revised policy on concurrency stacks up well against their national peers. Double-booking his first two cases enabled Wood to conduct three major operations on the day of Mengs surgery, logging a collective 21 hours as attending surgeon. When Dr. Neelakantan Sunder, team leader for orthopedic anesthesia, raised questions about Wood booking two rooms for major spine surgery in 2010 two years before the Meng case Dr. Peter Dunn, medical director of the hospitals OR, reassured him in an e-mail obtained by the Globe that Wood has the fellow manpower to do this., Sunder, who could be prickly about what he considered matters of patient safety, replied: Do you really think it reasonable to do these two cases by the same primary surgeon? He also said that publication of allegations based, he believes, on innuendo, incomplete and inaccurate data and mischaracterizations could clearly harm a group of surgeons who every day provide a world class service to our community.. For more information about these cookies and the data General. Learn more about our surgical optimization program, which will help you plan and prepare for your upcoming procedure. But, even as hospital officials developed the revised policy, new disputes erupted, including Burkes discovery that Wood was the attending surgeon for a second concurrent operation while he was doing back surgery on Red Sox pitcher Bobby Jenks in December 2011. Learn about career opportunities, search for positions and apply for a job. to analyze our web traffic. We want to get you back to doing the things you love. Thanks, Sunder. No one knew it at the time, but it was, for Burke and MGH, the triggering moment in a seven-year conflict. General officials said that Bhattacharyya provided superb care to this patient, and that his other cases had no impact on his treatment of the French patient. History of the Fernstrom Ball, BAK and Spine-Tech Part I, Orthopedic Surgeon Sues NY Health System for $24.7M, Ortho Surgeon Whistleblowers Sue Erlanger Health System, Dynamic Digital Radiography Better for Shoulder Injuries, Orthopedists Happiness Declined After Pandemic. He recalled Burke coming into his office in late 2009 and launching a fusillade of threats. Dennis BurkeDennis William Burke, M.D.Orthopedic surgeon is a big burly presence with flashing eyes under bushy eyebrows, a man of obvious personal force, intellectual aspiration, and famously deft hands. Dr. Christopher Bono Director, HCORP The Harvard Combined Orthopaedic Residency Program has existed for more than 100 years, and we are proud of the rich tradition of educating outstanding clinicians and leaders. Hospital attorneys say Wood acted appropriately and within the acceptable standard of care. Rubash, according to a hospital spokeswoman, says the meeting with Burke never took place. At 7:42 a.m., Dr. Kirkham Wood began a complex spine procedure on a 70-year-old woman in OR 64, according to medical records and legal documents. Don wanted to get back to a pain-free life. The Department of Orthopaedic Surgery is a world leader in treating the full spectrum of musculoskeletal conditions from sprains and strains your children experience on the athletic field to limb-sparing oncology procedures; from carpel tunnel syndrome to complex spinal reconstruction. The patient was reduced to tears, started to have a full blown panic attack, wrote WollmanLisa T Wollman-Kliman, M.D.Anesthesiologist. If I had known, I wouldnt do the surgery.. MGH has no such mandate listed in its policy, but hospital officials say they have taken some steps that the Brigham has not, like specifically barring some procedures from being double-booked at all. Candidate must be an arthroplasty fellowship-trained, board-certified orthopaedic surgeon with an exemplary record that exhibits the . Surgeons are encouraged and expected to tell patients when theyll be absent for part of the surgery, an MGH spokeswoman said, but they are not explicitly required to do so. Learn about career opportunities, search for positions and apply for a job. Jon has a tendency of counting operating time versus actual case time. This site uses Akismet to reduce spam. MGH concluded that none of the injuries was the result of double-booking, but the hospital declined to provide details to the Globe. Learn about career opportunities, search for positions and apply for a job. Burke sided with Shervin, testifying against the hospital. Some tests may be necessary at that time, including x-rays, CT scans and MRIs. Any senior resident who could hold a knife could have done it, Phan said. The General Hospital Corporation. Congratulations on this new journey in your professional career. Mortality Following Surgical Management of Vancouver B Periprosthetic Fractures. Now, attorneys for three of Woods patients say that double-booking will play a prominent role in their malpractice lawsuits against the surgeon, including one filed by Meng and another by former Red Sox pitcher Bobby Jenks, who blames Wood for what he alleges was a botched back surgery in 2011 that ended his career. Though often called simultaneous surgeries, they do not, of course, involve the attending surgeon working directly on two patients at once. Orthopedics in some ways is well suited to the practice, proponents say, because many procedures unfold in fairly predictable fashion, allowing surgeons to plan their movements with reasonable precision. And what must patients be told about their care, and when? The risks are real; the benefits can be huge. Had he known Dr. Wood might schedule a second surgery overlapping his, he said, I would have gone somewhere else.. Goolsby and Shubin Stein, M.D. They in a sense have traded in their New England Journal of Medicine for the Wall Street Journal., Dr. Kirkham Wood, a graduate of Albany Medical College who later trained under a spinal deformity specialist in Minnesota, took on some of the most ambitious concurrent surgeries, a challenge, he acknowledged in court testimony, that was strenuous.. Blue Distinction Centers are healthcare facilities recognized for their expertise in delivering specialty care. After completing his work on Meng around 7:30 p.m., Dr. Wood went off to his third surgery of the day, a three-hour procedure, leaving the resident, MelikianRojeh MelikianOrthopedic surgery resident, to check on Tony Mengs neurological function. Bhattacharyya was part of Mass. He joined DunnPeter Dunn, M.D.Medical director of the OR in developing the hospitals revised policy on the practice, hoping the new guidelines would become, as Lillemoe later described them, among the most comprehensive and well-defined in the country. He also began communicating with Burke in often-sympathetic sounding language that made Burke hopeful that he had found an ally. Gregory was startled at the news, as was the judge in his malpractice suit against Wood. He was briefly assisted by a general surgeon. Burke met twice with Stern in July 2011. They are the eyes and ears for patients in their most vulnerable state, carefully watching vital signs for any disturbance. But the Meng case also highlights what critics of double-booking find alarming: Surgeries dont always unfold as they are expected to. During a recent interview at her home in Montpellier, France, she said she was angry to find out that Bhattacharyya was tending to other patients at the same time as her. Tony Meng came to MGH suffering from neck pain and tingling in his arms and fingers. Still, the Spotlight Team found that the 2012 Meng case reignited an extraordinary, long-running controversy at one of the nations top-rated hospitals over the propriety and safety of a fairly common but little studied practice that goes to the heart of a doctors obligation to his unconscious patient. He had lost all muscle responses in his arms and legs, and doctors still did not know why. Learn about the many ways you can get involved and support Mass General. She is an attending on the Hand & Upper Extremity and the Orthopedic Trauma Services. The orthopedic surgery department at Mass. Dr. Freiberg earned his undergraduate degree from Northwestern University, and he graduated from the University of Cincinnati College of Medicine. He said he had reached a breaking point, that he felt he had no choice now but to contact state regulators the Board of Registration in Medicine and the Department of Public Health. Yet the hospital did impose new limits on double-booking surgery after Burke spoke out, reining in what MGHs chief of surgery described in an e-mail echoing a phrase of Burkes, he says as the wild wild west era of concurrent surgery. Explore fellowships, residencies, internships and other educational opportunities. Other luminaries in orthopaedic surgery have headed the Department over the years, including Drs. Generals busy orthopedic trauma service, and on this day, he was very busy indeed. Search for condition information or for a specific treatment program. Dr. Torchiana, through a spokesman, said he also kept detailed notes about that meeting, but declined to share them with the Spotlight Team saying it was a private meeting. All Rights Reserved. ShervinNina ShervinOrthopedic surgery resident later testified that while he was gone, she helped mix the cement for the hip implant, but felt uncomfortable going further on her own. The group has successfully integrated with the numerous services that are needed to treat complex oncologic patients. MGHs rules satisfied those federal regulationsMedicare rules are designed in part to keep the government, which pays teaching hospitals to train residents and fellows, from overpaying for patient care. Wood said he believed the cause of the worrisome neurological responses could be compression on the spinal cord from the back side. to analyze our web traffic. Theres been huge success in doing [concurrent surgeries] in the cardiovascular field, said Dr. Brian Parsley, a Houston orthopedic surgeon and the former president of the American Association of Hip and Knee Surgeons. MGH officials declined to comment directly on the Meng case, saying federal patient privacy laws forbid their doing so. Double-booking also fit well with the business-like approach that Dr. Harry Rubash brought to Mass.

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