By Chris Lane
By Jeff Balke
By Aaron Reiss
By Angelica Leicht
By Dianna Wray
By Aaron Reiss
By Camilo Smith
By Craig Malisow
So now Kaye was heading to a hospital owned by CHS, which some doctors have accused of instituting bariatric programs without the right equipment, and without peer review.
This was among the complaints doctors at the CHS-owned Cleveland Regional Medical Center presented to the Texas Medical Association's advocacy committee in June, one month before Eva Marie McNew died. The committee's mission, as described by chairperson Susan Strate, is to promote quality care for patients.
In their presentation, hospital chief of staff Philip Wisiackas and former chief of staff Mark Kreit complained about CHS's "continuing policy of imposing cuts and ignoring major deficiencies that jeopardize patients' safety." Except for one member, the hospital board of trustees resigned in protest in 1999 for CHS's reckless policies, Wisiackas and Kreit claim.
According to the doctors, CHS hastily approved credentials for underqualified anesthesia nurses and violated hospital bylaws by referring all unassigned ER patients to a physician hired by the hospital. The hospital did this to have more control over cost of care and length of stay, according to Kreit.
Wisiackas and Kreit also objected to CHS's system of rating doctors' effectiveness by their patients' length of stay and cost per case. This was the way CHS distinguished its "top 20" doctors from the "bottom 20" in Cleveland, Kreit says.
Kreit, who was rated in the bottom category, says he and other doctors were threatened with losing their privileges when they spoke out against the new policies.
"They called it disruptive behavior, when you're trying to protect the best interest of your patients," he says.
The surgical department didn't even get a chance to protest when CHS said it was starting a bariatric program, Kreit says. CHS just decided there would be a program, and that was that.
But Kreit, who also sits on the hospital's credentialing committee, says Cleveland was not equipped for bariatric surgery. So when Srungaram applied for bariatric privileges, the committee was a bit perplexed -- there wasn't even a bariatric department. The hospital didn't have the facilities necessary for the extensive post-op care bariatric patients required, Kreit explains.
"Our point was, we don't have a program you can't just do bariatric surgery because you know how to do it, you have to have support," he says. But ultimately CHS squeezed the surgery department hard enough to get Srungaram his privileges, Kreit says.
According to COMPASS's old Web site, which was revised soon after the lawsuit against Srungaram and CHS, Srungaram and Syn performed bariatric surgery at Cleveland Regional Medical Center. However, CHS spokesperson Rosemary Walsh says she cannot confirm that Srungaram ever performed bariatric surgery there, because she doesn't even know if there ever was a bariatric program there. The Cleveland hospital doesn't appear on COMPASS's new Web site. Walsh declined to answer other questions because of the pending litigation.
CHS's attorney, Gail Friend, did not return phone calls. Kreit and Wisiackas also claim that the physicians on Highland's board of directors were appointed by the administration, not elected.
"They do not represent the desire and the views of the medical staff and repeatedly had objected [to] the medical staff decisions in favor of the administration, in such obvious trend to suggest malice," they stated in their presentation.
While the doctors urgently described a dire, life-threatening situation at Cleveland, the TMA's advocacy committee remained a rather impotent bunch.
Chairwoman Strate says all committee discussions are privileged and that the committee takes no significant action regarding complaints.
"We try to mediate and resolve differences between parties" was all Strate could tell the Houston Press."We don't take stands one way or the other."
On July 28, one month after the advocacy committee decided not to take a stand, Kaye Parsley and Srungaram were on a commuter flight to Lubbock. They stayed at the Ashemore Inn, COMPASS's hotel of choice for clients and visiting surgeons. Kaye was scheduled for surgery Tuesday, with Monday reserved for the testing that Srungaram never did in Houston. But Kaye says someone from COMPASS called her Sunday night and said the surgery had been bumped up to first thing Monday morning.
Kaye says the next morning was a blur of X-rays, blood work and gallbladder tests whose results weren't even ready by the time she was wheeled into the OR.
"It was just hurry, hurry, hurry," she says. "They never explained to me why it was important for me to be first."
Over the next 48 hours, Kaye underwent the bariatric surgery -- then more emergency operations at two hospitals, with experimental antibiotics flowing through her stomach's infected wounds.
Long before the first operation, Srungaram had told her not to bother bringing any relatives because she'd be home in no time. After the surgical problems, Kaye managed a weary call to her parents. They flew in and made the decision to approve the experimental drugs for their daughter.
As for Kaye, being thin and 40 didn't matter anymore. She just wanted to survive.
Strangely enough, Srungaram would be the first to publicly criticize Highland's bariatric inadequacy. While he and his attorney, Larry Thompson, declined to talk to the Press, Srungaram complained about the hospital in an August interview with the San Angelo Standard-Times.