‘Buyer beware’ extends to health care

It isn’t easy to be an astute medical consumer.

Time often limits how much investigation we do as medical consumers. But many of us still try, especially in choosing doctors. But even though you check on them through medical boards and their patients, speak with other doctors and do Internet checks, chances are better than good that you’ll never know all you’d like to know about a practitioner, that you’ll wish regulatory agencies were more forthcoming, that you’ll wish you had done more homework on a doctor.

I feel that way every time I’m praying as I get wheeled down to the operating room to get cut on. Or when I’m writing what amounts to a consumer piece on a medical procedure that features a physician.

You can’t help being uneasy, particularly because it often takes years before medical boards rule on a physician’s behavior.

The last thing I want to do is put a reader at risk.

Anyway, the day after an April 7 Las Vegas Review-Journal Health section story of mine appeared on balloon sinuplasty — studies showed the minimally invasive procedure which treats chronically blocked sinuses is effective with a high degree of safety — I received a troubling call from 73-year-old Sheila McDaniel, a nurse who lives in Bullhead City, Ariz.

She zeroed in on Dr. Terrance Kwiatkowski, the doctor licensed in Nevada and Arizona who was prominent in the article and a man on whom I ran checks. Medical boards in both states hadn’t reported a blemish on his record. Patients of his in Las Vegas had sung his praises, as had officials at Sunrise Hospital and Medical Center, where he was director of minimally invasive sinus surgery.

Did you know, she asked, that some Bullhead City patients say they got hepatitis C during procedures at his office there?

Talk about feeling uneasy.

As it turned out, a spokeswoman for the Arizona Public Health Department, which did more than a year’s investigation since 2012 on the clinic where he worked, said that not one confirmed case of hepatitis has been tied to the Bullhead City Clinic where Kwiatkowski practiced. And in June 2013, the Arizona Medical Board sent Kwiatkowski’s lawyer a letter saying a case against the doctor for violation of the Medical Practice Act was “thoroughly investigated” and “dismissed.”

Early in my Internet searching for that story, I’d Googled Kwiatkowski’s name and received page after page detailing where his offices were. After McDaniel’s call, I joined Kwiatkowski’s name with “hepatitis” and “lawsuit.” Immediately, a January 2013 Arizona newspaper story popped up from the Kingman Daily Miner. Two people may have contracted hepatitis C from the clinic where he worked, the paper reported. One former patient sued.

No doubt about it: I should have drilled down deeper in my initial Internet search. I should have combined Kwiatkowski’s name with “lawsuit” as I often do on stories about doctors. And I could have asked questions at the appropriate time, not after a story that had been written to help consumers was already published.

In November 2012, 500 patients who frequented a health care facility owned by Community Health Systems and Bullhead City Clinic were sent letters by the owners urging them to get tested for hepatitis and HIV. Endoscopes used for seeing inside nasal passages and sinuses, officials said, weren’t properly cleaned, so patients could be at risk.

I called Kwiatkowski. He said the reason he didn’t divulge that he and the clinic where he worked were targets of state investigations and at least one lawsuit stemmed from “knowing in my heart I did nothing wrong.”

He said he was simply a Bullhead City Clinic employee and had no responsibility for hiring other employees or cleaning endoscopes. The clinic operators, he said, were responsible for training employees in the right way to clean equipment.

He likened his situation to a surgeon going into Sunrise Hospital to perform a procedure.

“If the surgeon had to be responsible for also sterilizing the equipment, nothing would get done,” he said. “At some point, you have to have trust that things are being done the right way.”

(Interestingly, attorney Jim Crockett, who has won many medical malpractice cases for patients, agrees with Kwiatkowski. “How can you double-check for sterility for an instrument?” he said.)

Kwiatkowski said both he and his employers sent letters to patients about possible infection.

“I care about them,” he said. “I was as angry as anybody about this scare happening. At this point, I don’t think anyone got hepatitis at the clinic. When those 500 or 600 were asked to be tested, a couple tested positive, which is unfortunately about right in the United States. Many people have the disease and don’t know it.”

Robert Mosier, an attorney for a woman who believes she got the disease at the clinic where Kwiatkowski worked, said he doesn’t buy the doctor’s theory.

“He should have cared enough about his patients to make sure the scopes were cleaned properly,” Mosier said. “He’s captain of the ship. We’ll see how it works out in court.”

Texan John T. James, founder of Patient Safety America, agrees with Mosier.

“He’s (the doctor) in charge,” he said. “Patient safety must be first in his mind.”

That the positions taken by Kwiatkowski, Mosier and James all make good sense doesn’t surprise me.

It isn’t easy to be an astute medical consumer.

(By the way, an Internet search of Terrance Kwiatkowski inevitably brings up David Kwiatkowski — a traveling medical technician who garnered national publicity as he was sentenced last year to 39 years in prison for infecting dozens of patients in four states with hepatitis C through tainted syringes. He is no relation to Dr. Terrance Kwiatkowski. “My mother-in-law always worries people will think we’re related,” the doctor said.)

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.