By Camilo Smith
By Craig Malisow
By Jeff Balke
By Angelica Leicht
By Jeff Balke
By Sean Pendergast
By Sean Pendergast
By Jeff Balke
In the wake of the court order, relations between Fernandez and center staff deteriorated. Arguments were commonplace, sometimes while patients were within earshot. New radiation therapist Lana Miller, who doubled as the center's director and managed the day-to-day operations, frequently clashed with Fernandez. Eventually she would file an assault charge against him after a disagreement about the treatment of a patient.
More than a year later, Bellaire Cancer Treatment Center settled the case with Fernandez. The doctor would get full privileges to practice at the center and a promissory note for $350,000, to be paid in installments after the center's income reached a manageable level. Those privileges could only be terminated if Fernandez somehow got in trouble and lost his license or faced other restrictions.
In addition, according to the settlement agreement, the staff would be notified that everyone was now satisfied, and that "in the future, all parties are to treat each other with respect, and without acrimony of any kind."
If there was a lull in hostilities, it didn't last long. Less than a month later, Miller tape-recorded a heated exchange with Fernandez about the doctor's parking space. At one point, he warned that if she had his car towed, "I'm going to insult you, I'm going to hit you and I'm going to do everything."
Carlos Fernandez is proud of his career. He ticks off his many civic and professional accomplishments: born to a distinguished family of physicians going back four generations, board certified as a radiation oncologist in 1971, trained at M.D. Anderson, president of the southwest branch of the Harris County Medical Society, member of the international committee of the International Medical Graduates of the Texas Medical Association, president of the Institute for Hispanic Culture. He is a member in good standing of the staffs at four area hospitals -- Bellaire, Sharpstown, Twelve Oaks and Specialty Hospital of Houston. In March he was named president-elect of the Hispanic American Medical Association of Houston.
Fernandez, whose lower lip tends to jut out suddenly in a massive pout, considers himself a victim of a vendetta. Most of the charges against him, he points out, were fed to state regulators by the cancer center staff. And almost all of the witnesses against him, including the physicians who labeled his treatment methods as dangerous, have some connection to the center or Bill Kubricht. Harold Ward, for example, who testified at the State Board of Medical Examiners hearing that Fernandez had committed "gross malpractice," is currently medical director at the center.
And the board, Fernandez says, was predisposed to find him guilty as charged and suspend his license. "They had it already in mind that that's what they wanted to do," he says.
In particular, Fernandez believes that his accusers scoured the records and selected only the most egregious examples involving extremely sick patients. Having treated more than 12,000 patients in his career, he says, that's simply not fair. "These are the worst that they picked," he says. "Why don't they pick on the other 11,900-something cases?"
Besides, he says, of the seven cases presented at the hearing, four of the patients are doing well. Three traveled to Austin to testify on his behalf. The others, he insists, died of their disease, not his treatments.
But the board didn't buy it, and hammered Fernandez on the cases at hand. That included those of the patients who were on his side. One, Frank Newson, had received a gold seed implant for prostate cancer from Fernandez in May 1996. Rather than using ultrasound or another accepted method to see what he was doing during the procedure, the doctor implanted the seeds blindly and failed to check their location afterward. Later, an x-ray revealed that he'd completely missed the prostate and instead clustered the 13 seeds several centimeters away.
Though Newson hadn't suffered any ill effects from the botch, others weren't so lucky. Maria Trevino, who had what was described as a curable skin lesion on her leg, got a concentrated one-two punch of gold seeds and beam radiation that proved too much, too soon. The lesion turned into a severe ulceration that penetrated to the bone. Trevino's leg had to be amputated.
And Esperanza Moreno, who was treated by Fernandez for cervical cancer, received four gold seed implants and a number of beam treatments for a combined dosage of more than 21,000 rad. John Wilbanks, an independent physician who evaluated the charts for the state, testified that the amount of radiation was "excessive," and that "anything over 10,000 rad, you're really getting into serious problems."
When Moreno died in 1996, her pelvic area was so badly burned it looked like it had been grilled.
In addition to overdosing his patients, Fernandez was accused of other improprieties. Maria Trevino's daughter, Norma Gonzales, submitted an affidavit that Fernandez had been "rude and unprofessional" and at one point had shouted at her mother when she questioned the treatment. "Dr. Fernandez slammed his hand down on the desk and yelled, 'I have already explained that to you,' " Gonzales testified. Various witnesses stated that Fernandez failed to apprise patients of the risks associated with radiation or offer alternatives. Billing improprieties were alleged. He refused to appear before the cancer center's peer-review committee to discuss concerns about treatment, a serious breach of protocol.