Federal database of malpractice cases doesn't make public doctors' names, or where they practice

Day two | DNT INVESTIGATION

In the last two decades, 282 doctors licensed to practice in Minnesota have settled malpractice cases that accuse them of causing their patients serious injuries, including quadriplegia, brain damage and death.

Of those doctors, 22 have been sued more than once for those cases. Among them is former St. Luke’s neurosurgeon Stefan Konasiewicz, who has settled lawsuits accusing him of causing two patients’ deaths and causing another to be paralyzed from the neck down.

Who are the other doctors, and where do they practice?

That’s largely unknown, because the National Practitioner Data Bank, the federal database that tracks malpractice cases, doesn’t make public the doctors’ names or where they practice.

The database was created in 1990 not only to collect malpractice information, but also to compile disciplinary actions taken against doctors by hospitals and state and federal medical boards. Lawmakers were concerned that doctors sanctioned in one jurisdiction were “state hopping” — moving to another state to avoid scrutiny.

But in trying to prevent that, the National Practitioner Data Bank has largely failed.

At least 5,200 doctors have been disciplined in one state for providing substandard care, only to move to another state, where they’re again cited, a News Tribune analysis shows. This is despite the full database that includes physicians’ names being available to all medical boards and hospitals.

Of the 32,167 doctors disciplined by state and federal medical boards and hospitals, more than 740 have had at least 10 disciplinary actions taken against them — including 13 doctors who are licensed in Minnesota.

Dozens of the doctors with multiple disciplinary actions taken against them have also settled multimillion-dollar malpractice cases in which they’re alleged to have seriously disabled or killed their patients, according to a News Tribune analysis of the data bank.

Cases missing

The number of doctors who have been disciplined or who have settled malpractice suits in the U.S. is actually far higher than the database indicates, because the database is missing thousands of records.

A 2005 story by the Washington Post reported that 54 percent of hospitals have never reported a disciplinary action or malpractice case to the data bank.

Cynthia Grubbs, acting director for the data bank, told the News Tribune that number is still true.

“Hospitals only must report specific actions,” she said. “It needs to reach the criteria of a ‘reportable event,’ and hospitals generally will try to remediate or work with their practitioners before it reaches a level of reportable action.”

While federal laws require hospitals and insurance providers to report settlements, no fine or penalty has ever been levied for failing to report, said Grubbs, whose agency, the Federal Department of Health and Human Services, oversees the database.

One of the most costly lawsuits settled by St. Luke’s hospital and Konasiewicz, for example, isn’t listed in the database. Konasiewicz and St. Luke’s settled with Duluth resident Lorena LeBeau after a lawsuit she and her husband filed in 2007, claiming a surgical error caused by Konasiewicz left her a quadriplegic.

That case settled for more than $1 million, a settlement revealed through court records when St. Luke’s sued the insurance provider that covered Konasiewicz and the hospital. But the LeBeau case is not in the national data bank.

Konasiewicz does have four other malpractice cases listed in the database, including two suits alleging his treatment led to patient deaths. Only nine other doctors in Minnesota have that many cases involving a death.

When contacted about the findings, Konasiewicz referred a reporter to his attorney, St. Paul-based Mark Solheim, who did not respond to questions.

St. Luke’s hospital issued a statement, reading, in part: “Dr. Konasiewicz’s litigation history over his career is not worse than the average of other neurosurgeons’ experience in the region or in the country. While Dr. Konasiewicz has, like most neurosurgeons, been sued on occasion, he has never received a litigation judgment against him. In fact, in the only case against Dr. Konasiewicz that has gone to trial, the jury found that he did not commit malpractice and acted within the standard for neurosurgeons.”

The full statement can be found in Sunday’s edition of the News Tribune or online at duluthnewstribune.com.

The full statement can be read

href=http://www.duluthnewstribune.com/event/article/id/200283/group/News/ target="new">here.

Debate over privacy

Even though the database removes the names of doctors and hospitals and is missing some records, it still has proven to be a powerful tool for researchers to track problem doctors and the actions taken against them. The nonprofit watchdog group Public Citizen, for example, used the database to find thousands of cases in which state medical boards failed to discipline physicians despite their own hospitals taking actions against them.

“Even without the names of the hospitals or the doctors, there’s useful information,” said Dr. Sydney Wolfe, a founder and director of the Health Research Group for Public Citizen. “Just imagine what would happen if you could actually look up the doctors by name.”

Which is why Public Citizen and other watchdog groups continue to lobby to make the full database public, as Wolfe said was the initial plan when it was first proposed.

But lobbyists for the American Medical Association stepped in, Wolfe said, and convinced Congress to redact crucial parts of the data.

The AMA says the data is flawed and incomplete and therefore inappropriate to make fully available to the public.

“We’ve always supported patients having access to reliable information about physicians as a means of improving patient safety and protecting patients from preventable harm caused by incompetent or unethical health-care practitioners,” said Cecil Wilson, an internist in Winter Park, Fla., and president of the AMA. “The important part of that statement is: reliable information. The problem with the NPBD is that it is seriously flawed, is an inaccurate system.”

Wilson said the best source for patients to find out whether their doctor has been disciplined is to look at a state medical board’s records.

But Lisa McGiffert, the campaign manager of the Consumers Union’s Safe Patient Project, which advocates for more physician accountability, said medical board information is often difficult to obtain and doesn’t contain crucial records, such as malpractice cases.

“If I’m checking out a doctor in Minnesota who came from another state, the only resource I have to is check that state’s medical board records,” she said. “And that can be very difficult to do.”

A centralized database would give patients more information about their doctors, McGiffert argued.

To make the data public would require an act of Congress.

“And so far, no one’s willing to do that,” Wolfe said. “There don’t seem to be any champions, at least that we can detect.”

News Tribune director of information technology Michelle VanDell contributed to the data analysis for this report.

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