Monday, October 8, 2007

Corruption at Emory University:Opening a Pandora's Box (UPDATED)

When Erick, at Redstate, published a piece about corruption at Emory University, I thought it was an interesting story and I published a follow up on my own blog. At the time, I had no idea the padora's box that I had opened.

Last night, I had a three hour conversation with a whistleblower by the name of Kevin Kuritzky. Kevin was 41 days from graduating from medical school at Emory University when he was expelled.

Emory claims Kuritzky was dismissed for "plagiarism, repeatedly missing required clerkship training involving patient care, lying to his professors, and engaging in other unprofessional, dishonest and unethical conduct."

But according to a complaint filed Jan. 31 in DeKalb County Superior Court, Kuritzky believes something else was a factor in his expulsion.

Kuritzky claims in the lawsuit that Emory officials kicked him out after he complained about patient safety and possible health care violations at Grady Memorial Hospital and the Veterans Administration Medical Center. Both medical centers are associated with Emory's medical school.

Well, what Kevin told me last night could never be summed up in one blog post. In fact, it is ripe for a book and a movie, and so I will be featuring a series of blogs about this matter.

In my first, I want to talk about how Emory's corrupt practices lead to poor people and Veteran's receiving egregiously below standard care because it was simply unprofitable for Emory to provide good care.

Emory runs a handful of hospitals in their Emory University Health Care System. Grady is the largest however because it serves the indigent, the poor, it is also the most unprofitable. Because of this peculiar relationship in their mix of hospitals, this is what ultimately lead to what Erick described as double dipping. What this meant was that residents and attendings who were supposed to be on call at Grady and the VA hospital would leave and go to one of their more profitable hospitals like the Emory University Medical Center.

At Grady almost everyone was either on Medicare or Medicaid or even worse they had no insurance. This meant that no matter how extensive their treatment their bills were limited. In fact, Grady merely paid Emory University a one time fee once per year regardless of the services provided. At the other hospitals the attendings and residents could charge the patients for their services and since the patients were much more affluent they could afford the extensive services the Emory doctors provided. Emory would then profit much more from extensive care provided at one of those hospitals than they ever would from providing extensive care Grady or at the VA.


What this lead to was residents and attendings who were supposed to be on duty at Grady or at the VA, leaving their posts and heading over to one of the other hospitals like Emory Medical Center. As a result medical students, like Kevin, were left in charge of entire floors of patients. Kevin said that he himself was left in charge on 5 different occasions. Doing this is like leaving a flame on. Most times nothing will go wrong but it is only a matter of time before the flame catches on fire.

One night that is what happened. One time he was left in charge of the entire step down unitfrom 4 PM to 2AM. The first emergency came from one patient who was recovering from lung surgery. The patient's lung collapsed and Kevin was called in to save his life. The patient was suffocating and time was of the essence. Kevin was panicked and needed to move quick. He needed to find a chest tube, but because of his own inexperience, he didn't know where they kept the chest tubes. In a rush, he did the only thing he could think of at the time. He grabbed the dirty chest tube that had already been used on the patient and injected into their lungs.

Next, Kevin was asked to read an x ray of the patient's lungs to determine if they were stable. This is again not something a medical student is supposed to do on their own and without supervision but since their was no supervision there wasn't much choice. Kevin gave it his best estimation and determined the patient was fine however as it turns out that was just a lucky guess. This patient survived but it had nothing to do with the type of care that was provided them at Grady.

On the same night, Kevin, again being the head doctor on the floor, was asked to save a patient from internal bleeding who was recovering from a heart attack. He was first asked to perform a hematocrit level test , which measures the amount of internal bleeding and then perform a blood transfusion on the patient. Again, he did this all without proper supervision.

The most egregious lack of quality health care that Kevin documented came with patients that came in for potential heart attacks. In order to determine whether or not a patient is in fact having a heart attack doctors perform what is known as a cardiac enzymes test. Proper procedure is to perform this test within 90 minutes since of course time is of the essence in a case of a heart attack. According to Kevin's documentation, the average wait time for performing such a test was about seventeen hours.

There is really only two reasons why a test that needs to be done in 90 minutes would be done in roughly 17 hours. The first is simple negligence. The doctors just didn't care or maybe they were incompetent which is also possible since as I documented many times the doctors in charge were themselves medical students.

The second reason is even more nefarious. If it is determined that someone is having a heart attack, then there needs to be a battery of tests, surgery, and weeks of recovery. This would cost a lot of money for the hospital and by extension Emory University. Since the patient on Medicare, Medicaid, or worse without insurance altogether, has limited funds, it is much more cost effective if that patient died.

This is only the first in my series. Anyone that wants to speak with Kevin themselves please contact me and I will get you his information.

UPDATE:
I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

12 comments:

Anonymous said...

A judge ruled in Emory's favor on this one (See mention below from a highly regarded education publication). The Atlanta community needs to stay focused on the larger issues of how to transform Grady so that it can become solvent.

ALLEGED NEGLECT: A lawsuit filed by a former medical student at Emory University who alleged that it neglected patients at its two teaching hospitals was dismissed last month by a Georgia judge who ruled summarily for the university. The former student, Kevin D. Kuritzky, was dismissed from Emory's medical school 41 days before he was scheduled to graduate, in 2005. He said university officials were angry that he had exposed the neglect of patients and, in retaliation, expelled him. The judge in the case, Robert J. Castellani of the DeKalb County Superior Court, sided with the university, writing, "The allegations brought against the student for dishonesty, and unprofessional and unethical conduct were numerous."

Chronicle of Higher Education

http://chronicle.com
Section: Money & Management
Volume 54, Issue 7, Page A30

http://chronicle.com/weekly/v54/i07/07a03002.htm

Anonymous said...

Except Castellani was an Emory Prof, his wife gets awards from Emory, and he and his wife give money to Emory.

mike volpe said...

I sent your comment to Kevin and here is how he replied...

Except that there are 2 problems:
Emory never made numerous allegations against me. Secondly, the judge never disclosed that he had been giving money to Emory during my case. Thirdly, the case wasn't dismissed - it is in the Appeals Court. Fourthly, Emory had their PR guy, Ron Sauder call the Chronicle and tell them these fallacies. Fifthly, this comment sounds strangely like Kent Alexander's comment in the AJC this morning about the unsealing - it sounds familiar:

"The real victim in all of this is Grady, the largest public health hospital in the Southeast. Grady is struggling to survive while misinformation circulates that, unintentionally or intentionally, diverts attention from the real issues." - Kent Alexander and Tim Jefferson AJC 10/10/07

Anonymous said...

Ok, this story is ridiculous. I graduated from Emory medical school in 2007, and no scenario such as the one Kevin described ever happened to anyone I know. We were never left alone in charge of entire floors; that is completely preposterous. And even if I had been, I would have known enough even as a third-year med student to ASK SOMEBODY WHERE THE CHEST TUBES ARE rather than abandon sterile technique and try to insert a dirty one. My guess is that they dismissed him for some real grievance, and he is claiming to be a whistleblower to cover himself.

mike volpe said...

Oh, another anonymous person claiming that Kevin who is not afraid to use his name is lying. Tell me, am I making up the case of State Senator Charles Walker? How about the Medicare fraud? What about the CMS report that said the patients were in extreme and immediate danger? Was all that made up as well? How about the Financial trouble that Grady is in? Is that made up also? I suggest that anyone who is still unsure who is telling the truth should read my piece WHO Is The Real Sociopath?

mike volpe said...

One last thing, Mr. Ms. Anonymous, you make it seem as though you have never heard of Kevin however according to my stat counter you found my site through a google search of Kevin Kuritzky. It sounds as though you were scouring the internet looking to smear him. If that is so I suggest you Read another of my pieces Smearing in the 21st Century. Your kind is obvious and predictable.

Anonymous said...

Due to some involvement in the ongoing lawsuit by Kevin against Emory, I am unable to reveal my name but was interested to see what was going on with the case. I never knew there was so much publicity surrounding the case and it was interesting to read about both sides for once. I believe in due justice but wanted to clarify a few things.

1. Although I am unable to give details, Kevin's pattern of behavior should have led to his expulsion way before his senior year. This went beyond "simple" things as tardiness and even plagurism. Unfortunately for other Emory grads, there were other students displaying "unprofessional" behavior at the same time and they were treated the same. I agree the timing of his expulsion raises some eyebrows, but nothing that he "revealed" was a secret.

2. Speaking of which, Kevin loved to exaggerate the truth and was a great story teller. At no time at the VA was he left unsupervised. The events did happen, but it was residents (who are always there) that "saved" the patients. No one used an unsterile chest tube nor did he give life-saving blood. In fact, students can't even write orders at the VA due to their computer systems (which if any of you actually worked in that system would know immediately that nothing can be done without entering orders on the computer). Oh ya, forgot to mention that students don't work overnight, as the time frame in the blog indicates.

3. Grady is essentially our charity hospital but people don't realize that Emory and Morehouse have a dedicated staff just for Grady. True, some depts like psychiatry and dermatology cover all of the hospitals due to the low volume individually at Emory, VA, Crawford, and Grady, but then again they wouldn't have sick patients on their service and nor would he be on a service like that as a medical student. As for subpar care, I agree, but that is the function of not having any money and the patient population. It is in fact amazing what Grady can do with the resources available to them and Americans should be ashamed that we have to do this living in this country. But that is another topic and regardless of how you look at it, we will always have to cut corners at Grady in order to do what is right for the patient and have been doing so for years. Kevin was not a whistle blower; he just timed it perfectly to make him seem like one.

4. I am extremely disappointed in how Emory has dealt with the other cases involving professors, faculty members but I cannot comment on those as I do not know the details. Emory has made several bad judgments and I believe they'll be punished in the long run. It's disappointing though when someone like Kevin manipulates the media to look like a saint even when he has acknowledged to committing unprofessional behavior. Btw, is anyone actually reads the medical conduct code at Emory, it states that a student can be expelled for the "first" offense. It's sad that he was expelled after 4 years when in reality he should have after the 1st year, but overall he has destroyed the credibility of all of the wonderful doctors (well some aren't but that's life) and could result in even more people with no access to health care.

I personally don't care if Kevin wins or not, but consider if you would want someone like him to be your doctor?

mike volpe said...

Mr/Ms Anonymous number seven. Where do I start? First, another anonymous poster claimed the case against Kuritzky. How could you be involved in litigation between Emory and Kuritzky if that case has been dismissed?

Second, you claim to have knowledge of things that Kevin said happened with only him in the room. Unless you were the patient, you wouldn't know. Kevin maybe lying however you cannot possibly state anything you claim as fact because you weren't there. If Kevin claims this event happened when he was alone, then how could you know it happened. Kevin wasn't pointing out that someone's lung collapsed and that the patient needed immediate treatment.

That IS WHAT HAPPENS IN HOSPITALS. Kevin pointed out that he, a med student, treated this patient ALONE. If he was making this up, I am sure it could be proven, however not by claiming the event happened another way. That sort of even probably happened a lot, Kevin's point was that one time it happened when he was alone.

Third, Kevin is not my only source on this case, and every other source confirmed what Kevin told me, and furthermore, those sources were confirmed by Google searches of cases.

You claim that while Grady has problems those problems are misunderstood. I say the facts speak for themselves. The JCAHO has done to Grady what it has done once previously in its entire history. That was with King Drew Hospital and the specifics of that hospital were out of a bad nightmare. You can spin this all you want however in this case, Res Ipsa Loquitur.


Finally, in the wonders of modern technology, I have identified the IP address that your comment originated from. I will find you and then you can explain how you are privvy to a lawsuit that is supposedly not happening.


Your IP address is 71.56.116.54

Your host name is c-71-56-116-54.hsd1.ga.comcast.net

and you visited my blog four times between 8:49:48 Central Time and
9:39:32

Anonymous said...

Thanks for pointing out my errors. I will now start believing everything I read on google, especially blogs that supposedly claim to promote the truth.

Goodluck to the KK fan club.

mike volpe said...

Here is something interesting...

http://my9.statcounter.com/project/standard/magnify.php?project_id=3020115&ip_number=1194882102

This stat counter page reveals the same IP address as before and it was on my site at the exact same time is this new ANONYMOUS comment was published.

This commenter had nothing to say about the obvious contradiction he has with the other ANONYMOUS poster who also tried to slander Kevin only their stories are divergent.

My reference to Google is not the articles they post on there, but rather their searches. For instance, a search of State Senator Charles Walker finds his indictment and a plethora of stories about the case.

A Google search of Medicare Fraud at Grady Hospital finds the disposition of that particular case. It is those sorts of searches that are ultimately my biggest sources throughout most of the stories.

Responding at this point is somewhat beneath me because the ad hominem attack with nothing else behind it is admitting defeat in and of itself.

Ultimately, your IP address is available for everyone and soon enough your real identity will be figured out.

If you are privvy to a lawsuit involving Emory and Kuritzky why haven't you spoken to the Wheel about making a correction? According to that newspaper, there is no lawsuit.

The Truthbearer said...
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The Truthbearer said...
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