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.