Medicine in Kermit Part 2: Nurses Awarded $750,000

The two ousted nurses of Kermit have settled their suit. I link here to a scathing article about it on the Law-Med Blog (adult language warning)! The same blog is so enamored by this long-running story that they awarded Winkler County its own page, detailing the whole history of the scandal, on their site.




Another article about the settlement appeared in The New York Times:

Texas Nurses Fired for Alleging Misconduct Settle Their Suit
By KEVIN SACK
Published: August 10, 2010
Two nurses agreed Tuesday to split a $750,000 payment from Winkler County, Tex., to settle the lawsuit they filed after being fired and criminally prosecuted for reporting allegations of improper medical treatment by a doctor at the county hospital, their lawyer said.

One of the nurses, Anne Mitchell, was acquitted in February of misuse of official information, a felony, for anonymously reporting Dr. Rolando G. Arafiles Jr. to the state medical board in 2009. Charges against the second nurse, Vickilyn Galle, were dropped shortly before the trial.

Experts on whistle-blower protection laws said the prosecution seemed unprecedented, and the nurses’ cause was taken up by state and national nursing associations that warned of a chilling effect on the reporting of medical misconduct.

Ms. Mitchell, 53, said in an interview that she was glad to put the case behind her. “We’ll be able to move on with our lives,” she said. “We never thought we’d be in this situation at this stage, when we should be settling down and looking toward retirement.”

Ms. Mitchell and Ms. Galle, both of whom live in Jal, N.M., have not been able to find work in the field since their dismissals as nursing administrators last year, said Brian Carney, one of their lawyers.

The nurses’ lawsuit, which was filed in federal court, asserted that they had been subjected to vindictive prosecution and denied their First Amendment rights. The hospital and other defendants agreed to the settlement without acknowledging liability.

Dr. Arafiles, who attended medical school in his native Philippines before training in the United States, was charged in late June by the Texas Medical Board with numerous violations, including “failure to maintain adequate medical records, poor medical judgment, poor decision-making, overbilling, improper coding, nontherapeutic prescribing and/or treatment and intimidation of witnesses.”

The complaint alleges substandard treatment of nine patients in 2008 and 2009. Dr. Arafiles is accused, for instance, of suturing a rubber scissor tip to a patient’s finger, using an unapproved olive oil solution on a patient with a highly resistant bacterial infection, failing to diagnose appendicitis and conducting a skin graft in the emergency room without surgical privileges.

(More details of Dr. Arafiles's alleged actions may be found here. - DK)

He continues to work at Winkler County Memorial Hospital in Kermit. He is awaiting a hearing before an administrative law judge on the medical board’s charges. His license could be restricted or revoked.

In 2007, the board placed limits on Dr. Arafiles’s license for three years after reviewing allegations of unprofessional conduct and inadequate supervision of subordinates at a weight-loss clinic where he worked.

Neither Dr. Arafiles nor Stan Wiley, the hospital administrator who fired the nurses, could be reached for comment. The nurses had named them as defendants, along with the county, the hospital and other local officials.

In April, the Department of State Health Services fined the hospital $15,850 for inadequately supervising Dr. Arafiles and firing Ms. Mitchell and Ms. Galle.

The nurses, who were responsible for quality assurance and regulatory compliance, said they began having concerns about Dr. Arafiles soon after he was hired in 2008 by the hospital, which has difficulty recruiting physicians to remote West Texas. Kermit, in the heart of the Permian Basin oil fields, has 5,200 residents.

Feeling that their internal warnings were not heeded, the nurses, who had a combined 47 years of employment at the hospital, wrote to the state medical board anonymously and referred investigators to cases listed by number but not by patient name.

After being informed of the board’s inquiry, Dr. Arafiles persuaded the county sheriff, Robert L. Roberts Jr., a personal friend and patient, to investigate who had filed the complaint. Sheriff Roberts obtained a search warrant to seize the nurses’ computers, found the draft on Ms. Mitchell’s hard drive and brought the case to a grand jury.

At trial, prosecutors asserted that Ms. Mitchell had not acted in good faith, as required by state law, when reporting Dr. Arafiles. The jury took less than an hour to find otherwise.

A version of this article appeared in print on August 11, 2010, on page A11 of the New York edition.