Doctors Behaving Badly: Practice doesn't always make perfect for New York ER doctor
Physicians are not computers.
One cannot expect them to retain every piece of medical knowledge that they learn over the years and apply it perfectly in every instance.
When a physician's bad calls and missed diagnoses start to form a pattern, though, hospital administrators and medical boards need to take action.
Dr. Jean Francois Hibbert, an emergency room physician in Elmsford, New York, has stitched a jagged and dangerous pattern over the past two decades. After multiple run-ins with the state's medical board, he continues to practice.
Consider these cases that can be found in records from the New York State Board for Professional Medical Conduct:
In April 1994, Hibbert saw a 30-year-old pregnant woman complaining of lower abdominal pressure. She told Hibbert that she had suffered two miscarriages. He did not conduct an adequate physical of the woman, perform any diagnostic tests or do anything else that would have helped him figure out that she was showing symptoms of an ectopic pregnancy that needed immediate care.
In October 1994, Hibbert saw a 42-year-old man complaining of chest pain radiating to his right shoulder. Hibbert gave the man a dose of nitroglycerine and noted that the pain went away. But Hibbert did not take the appropriate next steps, conducting a full physical and running the man through the appropriate tests. He should have admitted the man to the hospital or, at a minimum, called in a cardiologist for a consultation.
In April 1996, Hibbert saw a 14-month-old boy who had been in a car accident. Again, he failed to conduct an adequate physical exam or perform any diagnostic tests. As a result, Hibbert missed the fact that the baby boy had fractures in both legs that required immediate treatment.
For these three patients, Hibbert was charged by the New York medical board with gross negligence, gross incompetence, and multiple acts of negligence. The board put him on probation for one year beginning in May 2000 and ordered him to work under the supervision of another physician during the probation. The board also ordered him to complete at least 50 credit hours of continuing medical education in emergency medicine.
Some of these lessons probably stuck. But, not being a computer, Hibbert also lost some of that information. Here's what happened next, according to records from the New York State Board for Professional Medical Conduct:
Barely out of probation, in December 2001, Hibbert saw a 73-year-old woman in the ER at Catskill Regional Medical Center. She had an erratic heart beat and dizziness and a past history of diabetes, hypertension and heart failure. Hibbert did not take note of her high blood pressure or slow pulse rate.
In August 2002, a 38-year-old woman arrived in the same ER complaining of abdominal pain, lack of appetite and inability to work. She had undergone ovarian surgery in the past. Hibbert should have ordered an analysis of her urine and bacterial cultures.
In July 2003, an ambulance brought in a 41-year-old man who had been found on the floor, the possible victim of a drug overdose. Hibbert did not order fluid replenishment, any treatment to help restore the man's electrolyte balance, or antibiotics.
More charges from the medical board followed, and, once again, Hibbert was placed on probation, this time for three years beginning in April 2009. He was ordered to work under a practice monitor and ordered to take a clinical competency exam.
Final question: What happened to all of those patients? In terms of transparency, this is the sole failing of the New York medical board. On the board's website, disciplinary records are easy to find and full of other details. Because so many doctors hold licenses in multiple states, New York is always a good place for patients to look if they want information about their doctor's history but find themselves blocked by their own states. (Alaska and New Hampshire: hire a web-savvy intern and copy New York.) That's why it is surprising that the list of failures by Hibbert – and other doctors – does not include the ultimate outcome for these patients. Reading between the lines, one could deduce that at least a few of them ended up back in the hospital after Hibbert's misdiagnoses. But without this information, it is hard for patients to decide whether Hibbert is just a doctor still learning his "practice" or a medical menace.
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