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When Colleen Guidy went to see plastic surgeon Billy Ringer last December, she was feeling more than a little uneasy. Two days earlier she'd had her tummy tucked and breasts enlarged, and Guidy had questions. Her right forearm was still abnormally swollen, her right hand numb, and the right side of her chest hurt much more than the left. The procedure at Ringer's Center for Plastic and Reconstructive Surgery had taken almost eight hours, twice the usual amount of time, and no one could explain why. Not to worry, she'd been told on the telephone by Ringer's staff.
As Ringer palpated her breast during the follow-up exam, Guidy screamed in pain and backed away from him. Her husband, Quint, who had accompanied her to Ringer's northwest Houston clinic, became alarmed. Fear turned to rage, however, when Ringer scoffed at her agony. "He said, 'Stop whining, you fucking pussy,' " Quint Guidy recalls. He confronted the doctor: "I told him, 'Why don't I put one of those [implants] in you, shove it, and see who's the fucking pussy.' "
Ringer's medical assistant, Traci Williamson, also witnessed the exchange (she doesn't remember the obscenity). Williamson, whose son plays soccer with Guidy's son, had referred her to Ringer in the first place. Though she was embarrassed by Ringer's remark, Williamson says, "I felt like he was the doctor, what do you do?" Besides, "It was nothing out of the ordinary. That's how he talked to everybody."
Five days later Guidy was back to have her stitches removed. A nurse friend had told her to keep an eye on the incision, that it looked unstable and might rip. Guidy complained that her stomach smelled bad. "Incision looks good," Ringer later wrote on her medical chart. During the visit, the doctor dropped another bombshell: The tip of a suture needle had broken off in pre-existing scar tissue in her chest. Again, he told her, no problem.
Concerned that her condition might require a delay of the annual family Christmas trip to Atlanta, Guidy made one more visit to the clinic a few days later. The wound was beginning to split, but Ringer packed her a to-go care kit and gave the trip his blessing. The Guidys drove to Atlanta as planned.
The day after Christmas, the incision tore apart; Guidy rushed to the emergency room, where she was given heavy doses of antibiotics to fight the infection that had taken hold in her belly; an ugly, gaping wound was left where the surrounding tissue had died. Repeated calls to Ringer yielded only a message that the clinic would be closed till after New Year's. "We were not informed that he would be out of pocket after the surgery," Guidy says.
Eventually Guidy returned to Houston and was referred by Ringer's office to another plastic surgeon -- Ringer, she was told, was in rehab for a leg injury -- who treated her briefly at no cost. After conferring with an attorney, she sought another opinion, and her new doctor suggested an X-ray. The pictures revealed that Ringer was wrong about the tip of the suture needle in her chest. Rather, doctors told Guidy, he'd left the entire needle behind, on the right-hand side.
The more the Guidys learned about what had happened, the angrier they became. They heard from Williamson that Ringer knew he'd lost the needle but had neglected to tell them. They discovered that paying cash for cosmetic surgery is not at all typical, at least outside Ringer's practice. They found out he has no liability insurance. And they learned that Ringer had not been treating a leg injury while they were desperately trying to contact him, but was instead a temporary resident of a drug rehab clinic in San Antonio.
The Guidys have filed a malpractice suit against Ringer, and they're not the only ones: Williamson and her former co-worker, Michelle Barr, have also sued him, alleging sexual harassment, drug abuse and other infractions that led to their departure. According to court records, he's settled at least four malpractice lawsuits since 1994 for undisclosed sums. The Texas State Board of Medical Examiners has placed Ringer on five years' probation for sexual misconduct with a patient.
The board has the power to suspend or revoke licenses and put bad doctors out of business. But the process for doing so is gummed up by a shortage of resources to manage the caseload from within. Since a 1988 change in the system that was supposed to make it easier to go after malpractitioners, the number of physicians sanctioned by the board has actually declined. Even when the board does try to cleanse the ranks, the cases can be dragged through the courts for years. As a result, the board often opts for probation, which physicians will accept more readily. "It's better to have them restricted and practicing instead of just out there," says board spokeswoman Jill Wiggins. "At least that way we have some kind of leverage."
That leverage only works if the terms of probation can be effectively policed, or if they're sufficient to prevent further harm to patients. Wiggins can't say if Ringer is currently under investigation for violations, but no enforcement action against him has yet been initiated.