Starkman: C-Section Horror at Beaumont – Lawsuit Claims Surgeon Left Sponge in Patient’s Stomach

August 06, 2021, 7:41 PM

This columnist, a Los Angeles freelancer, is a former Detroit News business reporter who blogs at Starkman Approved.

By Eric Starkman

In the medical world there is something known as a “never event,” an incident so unacceptable and horrifying it's deemed inexcusable. One such incident is a healthy patient dying while undergoing a routine colonoscopy. Another is an obstetrics surgeon and her nursing staff leaving a sponge in a patient’s stomach after performing a C-section.

Beaumont Health CEO John Fox has these “never events” included among the carnage that’s led to the precipitous decline of the company’s once nationally respected flagship hospital in Royal Oak. Details of the C-section horror were disclosed in a lawsuit filed in February, but I’ve only just become aware of it. Beaumont has admitted the sponge was left in the patient, but insists she received an acceptable standard of care. The 36-year-old patient has been advised by doctors that damages to her uterus from multiple treatments relating to the sponge mishap might make it impossible for her to have children again.

In January, a healthy patient at Royal Oak died from intubation complications during a routine colonoscopy. The incident happened within three weeks of the hospital outsourcing its anesthesia to a controversial firm dubbed “Death Star” on an industry message board. The co-heads of Royal Oak’s cardiology department warned Beaumont’s then-chair John Lewis in advance they had “serious concerns” about the outsourcing firm, NorthStar Anesthesia, but it’s unclear if Lewis even bothered to read the message.

Beaumont CEO John Fox

The damage Fox has inflicted on Beaumont since he took over in 2016 is far more extensive than publicly known. The exodus of top-flight surgeons and specialists continues unabated despite – or possibly because of -- Fox’s Hail Mary plan to get Spectrum Health in Grand Rapids to rescue Beaumont from further decline.

Two breast surgeons with off-the-charts favorable reviews are leaving, and a very highly regarded interventional radiologist recently bolted. The head of Physical Medicine and Rehabilitation at Royal Oak was forced to resign after warning the hospital’s chief medical officer about the declining quality of care because of cutbacks.

Surgeries at Beaumont’s Royal Oak are routinely cancelled or postponed because of a shortage of surgical nursing staff. Multiple sources have told me that COO Carolyn Wilson misled NorthStar about the scope of anesthesiology support Beaumont Royal Oak required, and that NorthStar so far has lost money servicing its contract.

Beaumont COO Carolyn Wilson

Another issue is a shortage of support staff to clean surgical instruments and provide other services. Royal Oak’s so-called Central Processing Department (CPD) is down 40 workers. Recently, some tissue was discovered by a scrub tech on an instrument required for surgery after the patient was already anesthetized. The surgery had to be delayed while the instrument was returned to CPD for proper sterilization.

Even Beaumont Troy, the only hospital among the company’s eight facilities ranked five stars for safety by the Centers for Medicare and Medicaid Services, is fraying at the edges. A shortage of nurses to treat inpatients has forced the hospital to keep patients requiring admission to remain in the ER, taking up limited space and pushing an already stretched ER nursing staff to the brink.

Waits at Troy’s ER, once rare, have become so extensive that a patient recently coded -- meaning they became unresponsive and needed to be intubated. Sources say the hospitals' upper administration has shown no concern how dire the ER situation has become.

Sign on Woodward in Royal Oak

This reporting might seem at odds with the billboard Beaumont has posted on Woodward near its flagship campus touting U.S. News & World Report recently naming Beaumont No. 1 in Michigan for cardiovascular and heart surgery, orthopedics, and gynecology. I’ll let you in on a little secret: The rankings are based on dated data, much of it from 2018 and some going back as far as 2016, when Fox joined Beaumont and hadn’t yet trashed the place.

More Meaningful Ranking

Here’s a more meaningful, timely, and respected ranking. The Society of Thoracic Surgeons does a sophisticated grading program for cardiac bypass surgery and cardiac valve surgery. The quality measures include mortality, process measures, time until patient is extubated and discharge medications.

The lowest ranking is 1 and the highest is 3. The majority of U.S. hos pitals are ranked 2; historically Beaumont was ranked 2, and sometimes an exceptionally difficult to attain 3 ranking. Although the societyhasn’t released its latest rankings, it has advised Beaumont Royal Oak that it now has a 1 ranking, meaning the quality and mortality for its cardiac surgery now ranks among the lowest five percent of U.S. hospitals.

Underscoring the significance of Beaumont’s dismal ranking, Beaumont spokesman Mark Geary, who typically ignores my requests for comment, was compelled to issue this statement: “We have taken multiple steps to improve our quality ratings for cardiac surgery at Beaumont, Royal Oak and we’re confident that our patients are receiving compassionate, extraordinary care.”

As for Beaumont’s top-ranked orthopedic surgeons, they perform the majority of their procedures at rival area hospitals and ambulatory centers.

The bombshell allegations in the February lawsuit maintain that Dr. Ann Rehm, a Birmingham OB/GYN with decades of experience, and Beaumont's nursing staff left a surgical sponge in Southfield resident Meredith Dahlen’s abdomen after a C-section on Nov. 3, 2019, at Beaumont Royal Oak. Although surgeons are ultimately responsible for their cases, they rely on their surgical nurses to account for all the instruments and supplies used during procedures. The nurses Rehm relied on were Beaumont employees.

Beaumont in court filings concedes the sponge mishap, but insists Dahlen received an acceptable standard of care. Beaumont denies that Rehm is an “agent, representative, or employee of the hospital," despite her bio and photo appearing on the company’s website at this writing.

An affidavit filed by Stevie Dehnbostel, one of the nurses who assisted Rehm, claims that when Dahlen’s surgery was completed, the needle, sponge and instrument counts were correct.

“Based on this information, I believe the standard of practice was complied with,” Dehnbostel said in her affidavit.

Attorneys for Rehm filed an affidavit from Jody Jones, a Canton OB/GYN, disputing allegations that Rehm was negligent. The allegations, Jones said, are “untrue and were not the proximate cause of any injury and/or damage to Meredith Dahlen.”

Owning Up to Errors

According to Dahlen's attorney, Rick Groffsky, a partner with the Southfield medical malpractice and personal injury law firm Sommers Schwartz, and other attorneys I’ve spoken with, University of Michigan’s Michigan Medicine and Henry Ford Hospital often own up to medical errors and prefer to quickly settle cases involving egregious allegations of negligence and malpractice. Even prior to Fox’s arrival, Beaumont had a reputation for fighting and dragging out lawsuits, but the practice has continued since he named Jane Jordan general counsel six months after he took over as CEO. Jordan, like Fox, is from Atlanta, where both still have their primary homes.

Groffsky said he understands that doctors and nurses make errors. “The real story is the refusal of Beaumont to take responsibility for anything. Beaumont is responsible for its nursing staff and its own conduct.” Groffsky said his client is entitled to “very substantial” damages claims because he’s alleging negligence, not malpractice.

In Michigan, malpractice claims are capped at $851,000 for cases involving permanent injuries. However, there are no caps on ordinary medical negligence claims.

Geary, the Beaumont spokesman, didn’t address Groffsky’s lawsuit in his response to a series of questions I sent.

Grand Rapids-based Spectrum is known to have its own OB/GYN issues. In March, the local television station featured a story about residents posting photos on social media holding surgically removed organ and tissue material playing a mock version of “The Price Is Right.” The story made national news and Spectrum said it would investigate.

Under Fox’s watch, dozens of surgeons, anesthesiologists, and other specialists exited Beaumont because of unhappiness and distrust of his leadership. The latest surgeons to join the stampede include Nayana Dekhne and Amita Desai; Dekhne heads Beaumont’s breast cancer centers at Beaumont Royal Oak and West Bloomfield; Desai is also a breast surgeon at these locations. Both are highly regarded among colleagues and staff and have extensive patient reviews averaging 4.9 out of a possible five.

Dekhne in September will go into private practice at Michigan Health Professionals (MHP), a consortium of dozens of highly accomplished doctors maintaining their own private practices. Although Dekhne will continue to have surgical privileges at Beaumont, given her prominence and the patient loyalty she commands, other hospitals might try to lure her to use their facilities.

Desai is moving out of state. A third surgeon who works at Beaumont’s breast centers is on maternity leave. There is speculation that Ruth Lerman, a highly regarded internist specializing in breast care, may also bolt.

Dekhne and Desai couldn’t be reached for comment. Beaumont is currently running ads for breast surgeons. “They will bring in surgeons who we refer to as B-list,” said a source. 

Here’s what spokesman Geary had to say about Dekhne’s and Desai’s departures: “It’s not uncommon for physicians to shift back and forth between private practice and employed status. Beaumont has a team of breast surgeons, both employed and independent, who provide high-quality care to our patients.”

Another recent key departure was Dr. Andaya Roy, a top interventional radiologist specializing in various needle biopsies. Although Roy is still listed on Beaumont’s website at this writing, he in fact has gone into private practice at MHP.

Ron Taylor, head of Beaumont’s Physical Medicine and Rehabilitation, was recently forced to resign after he complained about how cutbacks were harming patient care. Multiple sources told me that Taylor is a conscientious “patient first” leader who’s worked at Beaumont for more than three decades. “Ron Taylor represents everything a Beaumont doctor once was and still should be,” said a source who has known Taylor for years.

Last year Brian Berman, the head of pediatrics at Royal Oak, was fired after he, too, complained cutbacks were harming patient care. A physician who protested Berman’s firing was also dismissed.

Beaumont recently announced that COO Wilson and Chief Medical Officer David Wood Jr. will depart in September. Fox is expected to depart in October in anticipation of Spectrum taking over. He possibly stands to earn tens of millions of dollars because of a change of control provision in his contract.

Beaumont has yet to disclose the terms of the deal or how the merged hospitals will use Beaumont’s $3.5 billion reserve. Although Beaumont and Spectrum characterized their marriage as a “merger,” in fact Spectrum’s management will assume full control of Beaumont. Studies conclusively show that hospital mergers result in higher costs for patients and lower standards of patient care.

It’s frightening to think that Beaumont’s standards could sink even lower.

Reach Eric Starkman at: Beaumont employees and vendors are encouraged to reach out, with confidentiality assured.

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