Respectful Insolence

About five months ago, I blogged about a true miscarriage of justice, the sort of thing that should never, ever happen. In brief, it was the story of two nurses who, disturbed at how a local doctor was peddling his dubious “herbal” concoctions in the emergency room of the local hospital when he came in to see patients, reported him to the authorities. Moreover, they had gone up the chain of command, first complaining to hospital authorities. After nothing happened for months, they decided to report the physician, Dr. Rolando Arafiles, Jr., to the Texas Medical Board because they honestly believed that this physician was abusing his trust with patients and behaving unethically by improperly hawking herbal supplements that he was selling in the rural health clinic and the emergency room of Winkler County Memorial Hospital.

Even though under whistleblower laws the identities of these nurses should have been kept secret, after he learned that a complaint had been filed against him Dr. Arafiles went to his buddy the Winkler County Sheriff Robert L. Roberts, who left no stone unturned in trying to find out who had ratted out Dr. Arafiles:

To find out who made the anonymous complaint, the sheriff left no stone unturned. He interviewed all of the patients whose medical record case numbers were listed in the report and asked the hospital to identify who would have had access to the patient records in question.

At some point, the sheriff obtained a copy of the anonymous complaint and used the description of a “female over 50″ to narrow the potential complainants to the two nurses. He then got a search warrant to seize their work computers and found a copy of the letter to the medical board on one of them.

The result was this:

In a stunning display of good ol’ boy idiocy and abuse of prosecutorial discretion, two West Texas nurses have been fired from their jobs and indicted with a third-degree felony carrying potential penalties of two-to-ten years’ imprisonment and a maximum fine of $10,000. Why? Because they exercised a basic tenet of the nurse’s Code of Ethics — the duty to advocate for the health and safety of their patients.

On Saturday, the New York Times reported on the story, as there have been significant developments since August. Specifically, although the charges against one of the nurses has been dismissed, Anne Mitchell, RN, is going to stand trial beginning today:

But in what may be an unprecedented prosecution, Mrs. Mitchell is scheduled to stand trial in state court on Monday for “misuse of official information,” a third-degree felony in Texas.

The prosecutor said he would show that Mrs. Mitchell had a history of making “inflammatory” statements about Dr. Rolando G. Arafiles Jr. and intended to damage his reputation when she reported him last April to the Texas Medical Board, which licenses and disciplines doctors.

Mrs. Mitchell counters that as an administrative nurse, she had a professional obligation to protect patients from what she saw as a pattern of improper prescribing and surgical procedures — including a failed skin graft that Dr. Arafiles performed in the emergency room, without surgical privileges. He also sutured a rubber tip to a patient’s crushed finger for protection, an unconventional remedy that was later flagged as inappropriate by the Texas Department of State Health Services.

Charges against a second nurse, Vickilyn Galle, who helped Mrs. Mitchell write the letter, were dismissed at the prosecutor’s discretion last week.

So let me get this straight (again). A dedicated nurse does what her professional code of ethics demands that she do, even knowing at the time that she did it that it might cost her her job, and the end result is that the good ol’ boy network in Texas tries to throw her in jail for years on trumped up charges that even the Texas Medical Board states are bogus. Even Ms. Galle won’t be unscathed. As the Texas Nurses Association points out, she will have a felony indictment on her record, which will haunt her the rest of her professional career. In fact, in all my years in medicine, I cannot recall a more blatant example of punishing a whistleblower or of the good ol’ boys network getting together to punish an uppity nurse who dared to call a doctor out on his unethical behavior, which was described in a bit more detail in the NYT story:

It was not long after the public hospital hired Dr. Arafiles in 2008 that the nurses said they began to worry. They sounded internal alarms but felt they were not being heeded by administrators.

Frustrated and fearing for patients, they directed the medical board to six cases “of concern” that were identified by file numbers but not by patient names. The letter also mentioned that Dr. Arafiles was sending e-mail messages to patients about an herbal supplement he sold on the side.

Mrs. Mitchell typed the letter and mailed it with a separate complaint signed by a third nurse, who wrote that she had resigned because of similar concerns about Dr. Arafiles. That nurse was not charged.

To convict Mrs. Mitchell, the prosecution must prove that she used her position to disseminate confidential information for a “nongovernmental purpose” with intent to harm Dr. Arafiles.

Although I did know that it had been alleged that the sheriff and Dr. Arafiles were in business together selling herbal supplements, thing that I hadn’t known before is that Sheriff Roberts had been a patient of Dr. Arafiles and credited him with saving his life. Apparently, because of his devotion to Dr. Arafiles, Sherriff Roberts went on a vendetta, blatantly and unethically abusing his power in an outrageously vindictive and punitive manner to track them down. One wonders if Sheriff Roberts spends as much energy, effort, and cleverness trying to hunt down real criminals (you know, like thieves and murderers) as he did in hunting down two middle-aged nurses who were just doing their duty. Moreover, from the NYT story, the justifications of Stan Wiley, hospital administrator for Winkler County Hospital, made it clear (to me, at least) that the reason the hospital is standing by Dr. Arafiles is not primarily because he’s a good doctor and the administration doesn’t think he did anything wrong, but rather because the hospital has a hard time recruiting doctors to west Texas, having recruited Dr. Arafiles even though he had a restriction on his license and had been in trouble with the state medical board before. Particularly galling and disingenuous was Wiley’s claim:

Mr. Wiley said he believed that the nurses had acted in bad faith because they went to the state despite his internal efforts to discipline Dr. Arafiles. But, he said, “I don’t believe they did it on a personal vendetta.”

No, the only people on a personal vendetta are Dr. Arafiles and Sheriff Roberts, and they’re using the clueless Wiley and County Attorney Tidwell as tools in their quest to punish the two Winkler County nurses. In any case, Wiley’s description is not the definition of “bad faith” under Texas law. “Good faith” does not require that the whistleblower wait for the hospital to act on reports against a doctor, contrary to the delusion under which Wiley labors. He may think not waiting for him to act is bad faith, but it’s not. Mitchell and Galle could just as well have gone straight to the Texas Medical Board without even trying to go through the hospital administration if they had wanted to and it would not have been bad faith. As the NYT story explains, under Texas law, good faith requires only a reasonable belief that the conduct being reported is illegal, and the Texas State Medical Board has backed the nurses and criticized this vile prosecution. Wiley is just plain wrong about this; it isn’t even close. The most likely explanation for his supporting this outrageous abuse of prosecutorial power is that hospital administration was roundly embarrassed (as it should be) when this story came out. It didn’t act; so Mitchell and Galle decided that they had to–and they were fired for it before Boss Hogg (I mean Sheriff Roberts) entered the picture. That these two nurses felt obligated to risk their careers (and, even though they couldn’t have known it at the time, their freedom as well) by reporting Dr. Arafiles to the Texas Medical Board derived not from bad faith, but from the ineffectiveness of the hospital’s response.

Indeed, the very fact that Sheriff Roberts and County Attorney Scott D. Tidwell continue to pursue this case to trial demonstrate that it is not Ms. Mitchell who’s engaging in a vendetta; it’s Dr. Arafiles through his buddy Sheriff Roberts and the clueless County Attorney Scott Tidwell who are all teaming up to engage in a bit of payback. It’s so blatantly obvious from even a cursory examination of the case, and a deeper examination only reinforces this point. The trio’s actions are utterly outrageous and unforgivable. There’s definitely something rotten in west Texas, specifically Winkler County, and, regardless of whether Dr. Arafiles is guilty of abusing his medical license and practicing medicine that endangers patients, its names are Dr. Rolando Arafiles, Sheriff Robert L. Roberts, and County Attorney Scott Tidwell. Regardless of whether Dr. Arafiles did anything wrong medically or ethically, these three men have done a grave wrong to Mitchell and Galle. I even have to wonder if what Sheriff Roberts did by going so far to unmask an anonymous complainant to the Texas Medical Board is illegal. If it isn’t, it ought to be.

You and I can help fight this abuse of power by contributing to Mitchell and Galle’s legal defense fund through the a link on the Texas Nurses Association website‘s front page. It may not do any good, but it may also be worth writing to the Winkler County Attorney Scott Tidwell and Sheriff Roberts to express (politely) opposition, dismay, and outrage. Let them know that the nation–no, the world–is watching. Point out that the Winkler County Attorney website cites Art. 2.01 Texas Code of Criminal Procedure, which reads: “It shall be the primary duty of all prosecuting attorneys…not to convict, but to see that justice is done.” Further point out that prosecuting Anne Mitchell is not justice by any stretch of the imagination. Mitchell and Galle’s careers have been ruined through this malicious prosecution; they can’t find work and may never be able to find work as nurses again, at least not in west Texas, and they’ve racked up huge legal bills trying to defend themselves. Don’t let Dr. Arafiles, Sheriff Roberts, and County Attorney Tidwell get away with it.

I hope against hope that Mitchell will be found not guilty and that Dr. Arafiles, Sheriff Roberts, Winkler County Hospital, and County Attorney Tidwell will pay dearly for their misdeeds, thanks to the civil suit that Mitchell and Galle have filed against them.

Comments

  1. #1 Alex
    February 8, 2010

    I threw in 50$. How much is needed to resurrect and hire Johnny Cochran? She can’t lose if she gets that guy for her defense. Is it possible to file criminal charges against Arafiles and his friends for abuse of power?

  2. #2 Adam Cuerden
    February 8, 2010

    Can’t they sue for abuse of power?

  3. #3 Mojo
    February 8, 2010

    …they have a hard time recruiting doctors to west Texas…

    I imagine that they might have trouble recruiting nurses as well.

  4. #4 Troy
    February 8, 2010

    Can’t we retroactively accept their succession from the union and let Mexico have them?

  5. #5 Bobington
    February 8, 2010

    I recently wrote to our states Board regarding a Pediatrician; now this makes me wonder if I could get in trouble for it.

    The chilling effect of this is huge.

  6. #6 DLC
    February 8, 2010

    This sort of thing shouldn’t happen. No law officer should ever be permitted to use his power to carry on a personal grudge.

  7. #7 David N. Brown
    February 8, 2010

    I have heard of “angels of death” cases (hospital staff killing patients)where the hospitals’ defense was that if they had warned other hospitals the person was a suspected killer, they could have been sued by the employee. I have treated this as a weak rationalization, but judging from this case even worse consequences would appear conceivable. Another thing about “angels of death” is that they “migrate” from one institution to another, as it appears Arrafiles has done.
    Also not that Texas is home to Thoughtful House, Apothecure and (to my recollection) ACAM headquarters. Is there something about the state that attracts medical fraud?

  8. #8 Grendel
    February 8, 2010

    Interesting – in the Winkler County Jail you can have cash, and one bible – and also underwear. Nothing else. Does this mean no other religious document? Is that discriminatory?

    Winkler County – one place that just doesn’t seem worth passing through

  9. #9 Marilyn Mann
    February 8, 2010

    *writes check for nurse’s legal defense fund*

    This is just terrible.

  10. #10 DayOwl
    February 8, 2010

    Where’s the State Attorney General in this? Why is the state standing by doing nothing? Oh, right…Texas, where miscarriage of justice has become an art form. They’re actually proud to execute the innocent there.

    At least they aren’t capital charges.

  11. #11 Todd W.
    February 8, 2010

    Donated. Best of luck to Mrs. Mitchell!

  12. #12 Lab Rat
    February 8, 2010

    Isn’t Winkler Country a place in the Wizard of Oz?

    That really is shit though, at least you guys don’t have libel laws making things even more manky.

  13. #13 MI Dawn
    February 8, 2010

    @Lab Rat (#12): No, you are thinking of the Winkies. The Oz books are all at home but IIRC, the land of the Winkies was yellow and the Tin Man was the head of it (after Oz flew away in his balloon…) It’s been a while since I read the books, so I may be wrong. Would check Wikipedia but can’t access it right now…I love my employer.

  14. #14 MI Dawn
    February 8, 2010

    Ah…google went through. Weird things moving very slowly today. Yes, land of the Winkies is yellow and the Tin Woodman was the head of it.

  15. #15 Kristen
    February 8, 2010

    I am going to do whatever I can. Not much, but I will also talk to my friends.

    This is just unbelievable! I read the article and this doctor calls himself the victim. The sheriff thinks he is above the law, and the court is just going along with it. I never thought something like this could happen in America.

    There is a shortage of nurses in this country, and these two are (were) some of the best. This is not only a miscarrage of justice, but a disservice to patients these nurses would have helped in their future careers that no longer exist.

  16. #16 Marilyn Mann
    February 8, 2010

    Oh, and although I have not looked at the Texas law in question, I agree with you that whether or not the whistleblowers had alerted the hospital authorities or waited for them to conclude their investigation is irrelevant to whether the nurses were acting in good faith (according to common definitions of good faith that I’m familiar with).

  17. #17 momkat
    February 8, 2010

    The exposure that the NYT article has given this case will probably give the nurses more of a chance for a favorable outcome, but it isn’t guaranteed. Small town politics can be unbelievably nonsensical. And some people see value in having a questionable doctor rather than none at all and will vilify the nurses. I believe they have filed civil lawsuits against the hospital, sheriff, doctor and prosecutor so maybe they can win significant damages to make up for lost income.
    OT, great story on NPR this morning about childhood vaccinations. Hopefully the transcript is on the website.

  18. #18 Pablo
    February 8, 2010

    Moreover, from the NYT story, the justifications of Stan Wiley, hospital administrator for Winkler County Hospital, made it clear (to me, at least) that the reason the hospital is standing by Dr. Arafiles is not because he’s a good doctor and the administration doesn’t think he did anything wrong, but rather because the hospital has a hard time recruiting doctors to west Texas,

    I’m surprised they wouldn’t have success getting some of the folks from the TTU med school to stay in the area.

  19. #19 debaser
    February 8, 2010

    Ahh yes, the good ol’ boy network. Never good, barely a network, but for sure, lots of Old Boys. Poor ol’ Boys, if someone made them play by the same rules as everyone else (especially the ones they get to enforce on others), why, them poor ol’ boys wouldn’t be good ol’boys anymore, just white men of low quality.

  20. #20 James Sweet
    February 8, 2010

    Interesting – in the Winkler County Jail you can have cash, and one bible – and also underwear. Nothing else. Does this mean no other religious document? Is that discriminatory?

    Wait a gol-dang minute… are you trying to tell me that there are places in West Texas that don’t respect the separation of church and state?

    I’m shocked, just shocked I tell ya!

  21. #21 Kim
    February 8, 2010

    As a “lower ranked” health professional, I find this disturbing. I expect to be able to follow proper channels to ensure patient safety. As a potential patient, I find this EXTREMELY disturbing. I expect to get the best possible care and for all employees at the hospital to be free to look out for my best interests.

  22. #22 nitramnaed
    February 8, 2010

    I gave them a little love.

  23. #23 Not the crazy one
    February 8, 2010

    This story is/will be on this afternoon’s NPR’s All Things Considered and will be available at link after broadcast.

  24. #24 Dangerous Bacon
    February 8, 2010

    I don’t blame the nurses in the slightest for filing civil suits to recover damages for what they’ve gone through. It’s sad that with the hospital being one of the targets, patients in the region might have to suffer for the actions of hospital administration.

    Wonder where the rest of the hospital medical staff has been during all of this? You’d think that if it’s that hard to recruit MDs to this place, a unified stand by the rest of them in support of the nurses would’ve given the administration something to think about.

  25. #25 Carbon footprint creator
    February 8, 2010

    HMMM… The last time I checked herbal supplements were not illegal and it was not illegal for a doctor to give them or suggest them to patients. I am not sure about selling them to patients. My eye doctor has sugessted Omega 3 and Lutein to me on more than one occasion. I suppose his criminal actions must be punished then? I think not. Looks like the guy who went to jail deserved it. Troublemakers always do.

  26. #26 Chris
    February 8, 2010

    From the link to the Statesman newspaper opinion page posted above:

    They were unamused by his improperly encouraging patients in the hospital emergency department and in the rural health clinic to buy his own herbal “medicines,” and they thought it improper for him to take hospital supplies to perform a procedure at a patient’s home rather than in the hospital. (The doctor did not succeed, as reportedly he was stopped by the hospital chief of staff.)

    It may be proper for him to suggest in his own private clinic, but not in the hospital emergency room! Nor is it proper for him to take hospital supplies away from the hospital.

    Plus, these were his own mixtures!

    Did your doctor suggest the supplements at his own private practice, or while you were strapped to a gurney in the emergency department waiting for help? Were the Omega 3 and Lutein commercially available at your local drug store, or were they your doctor’s special formulas?

  27. #27 gaiainc
    February 8, 2010

    Did you read about what else the doctor did on the ED that the Texas Medical Board agreed was inappropriate? Just wondering because that is bad. It’s not just about the herbal supplements that he was selling to patients.

  28. #28 Chris
    February 8, 2010

    I was only responding to the selling of supplements. The New York Times article (which was reprinted in my local paper) included these bits:

    she had a professional obligation to protect patients from what she saw as a pattern of improper prescribing and surgical procedures — including a failed skin graft that Dr. Arafiles performed in the emergency room, without surgical privileges. He also sutured a rubber tip to a patient’s crushed finger for protection, an unconventional remedy that was later flagged as inappropriate by the Texas Department of State Health Services.

  29. #29 Alan Kellogg
    February 8, 2010

    Foxnews had a story earlier to day on this subject. Unfortunately, Foxnews uses a real crappy search engine for their site, so I was not able to locate it on the site.

  30. #30 Svlad Cjelli
    February 9, 2010

    Why does the sheriff have that power to bend the law? Is that authority somehow ingrained in the flesh of a sheriff?
    Doesn’t that power depend on the state and law enforcement?
    Is he a fucking Super Sayajin?
    Does he have a robot army?
    Is he a wizard?

  31. #31 Mojo
    February 9, 2010

    Is that authority somehow ingrained in the flesh of a sheriff?

    Do you not respect his authoritah?

  32. #32 Jeff Darcy
    February 9, 2010

    Unfortunately, seeing that their actions have outraged folks in places like New York or Minnesota or Massachusetts will probably only spur these folks to greater efforts. Offending people like us is their highest aspiration. Does anybody seriously think that a Texas judge or AG is going to respond to a letter or a brief from any of us other than to do the exact opposite? Anybody who thinks that never met a Texas judge or AG, or even read about them in the news.

  33. #33 BlueMaxx RN NP
    February 9, 2010

    As a nurse who at one point in my career was working the Quality / Performance improvement/ Risk management offices of the hospital, I am shocked, disappointed, and angered. THIS is one reason why I always have carried my own Malpractice and Liability coverage, because of the fear that the hospital will suddenly switch from ” we have your back, do the right thing, we cover you under our insurance” to “good luck with your legal troubles and job search”

    While I do not pretend to have all the facts, it seems this ‘doctor’ was way off the tracks, already on ethical thin ice and restrictions. Internal reporting mechanisms did not fix the safety issues. External report to State Board seems to have resulted in an investigation that found FOR the nurses, the ‘doctor’ was in the wrong. The sheriff, who apparently feels no need to recuse himself from either the case OR the media, has seemingly never heard of conflict of interest, bias, or professionalism. The DA has an agenda I am unable to even guess at.
    The president of the medical staff needs to reread his oath, and perhaps his medical school admission essay. If I can channel Hippocrates for just a moment… ” WTF is going on down there?”
    This got to the point of the nurses reporting ‘outside’ because the inside reporting and safety system failed. The ‘good ole boys’ network seemed to be willing to sacrifice patient safety for mediocre medicine. He (Medical Staff President) is a professional embarrassment, along with whomever is the Hospital Director… (can you even have a ‘CEO’ at a 15 bed hospital?)

    I have elected to insert for my “personal” URL today, the TEXAS Nurses Association LEGAL DEFENSE FUND contribution site.

    https://www.paymyassociation.com/displayemailforms.cfm?SessionId=B34523BF-957C-FF35-74C8B8BA1501E1B0&emailformnbr=118027.

    Any nurse that works at that hospital should be strongly reevaluating career options and looking elsewhere. From what I read, there are hospitals in surrounding areas of 30-45 miles distance. In WEST Texas, that is ‘next door.’
    RUN from this place. Fast. Faster.

    WORST. HOSPITAL. MANAGEMENT. EVER.
    SHERIFF would make MEL BROOKS Laugh, then cry.

  34. #34 Pete D
    February 9, 2010

    Mitchell’s complaints weren’t limited to Arafiles selling herbal supplements to his patients. He is also accused of performing a skin graft surgery in a hospital that is not licensed to do so and where he does not have surgical privileges.

    The prosecution’s view is that Mitchell complained as some sort of personal vendetta against Arafiles and used her access to governmental info to aid in this. The letter from the Texas board stated that Mitchell’s actions were completely valid and legal, yet Arafiles pressed the local sheriff to investigate her. Sounds to me like Arafiles or the sheriff’s actions would constitute using access to government info for non-governmental purposes (i.e. Arafiles own personal vendetta against Mitchell). I would be surprised if Mitchell or the state does not file some sort of counter action against Arafiles and the sheriff.

  35. #35 Shannon
    February 9, 2010

    small town texas is dominated by the old boys network, unfortunately.

    The best chance the prosecutor has is to convince the jury that Arafiles was practicing some kind of satanism using his herbal remedies. That’ll go over real well with a west texas jury.

  36. #36 Michelle in DC
    February 9, 2010

    That makes me so angry I have steam coming out my ears. Definitely contributing to their legal fund. Can’t do much as a student, but every little bit counts, right?

  37. #37 Dale
    February 9, 2010

    This is absolutely ridiculous. It’s a horrible combination of woo and abuse of power.

    As a side note to the first commenter Alex, Cochran died in 2005 but I do agree they could use a good lawyer.

  38. #38 epador
    February 9, 2010

    My spouse is a quality honcho, and has been following this one carefully. It is indeed a nightmare all too likely in rural medicine.

    My spin is the nurses are lucky these West Texas ol’ boys picked the legal system rather than more traditional West Texas forms of retribution. If the ol’ boys appear to be losing, they may still resort to more base actions. Hope these women are packing heat or have good bodyguards.

  39. #39 ei
    February 10, 2010

    I know it’s a long-shot, but I’m hoping Winkler county residents wake up and vote out DA Amtrak and Sheriff Cartman. I suggest Texas residents write to the state governor to politely demand the immediate intervention and dismissal of this persecu… Erm, “prosecution.” Oh, and expunge the felony indictment from the nurses’ records.

  40. #40 Moms Hugs
    February 10, 2010

    This video is astounding – a case of Greed Gone Wrong! If the good doc got patients’ email addresses at the hospital to peddle his herbal supplements, HE should be prosecuted for Misuse of Government Information & the SHERIFF should be prosecuted for Abuse of Power.

    The population of fools grows exponentially it seems. What disturbs me is that 2 attorneys indicted & are prosecuting the nurses! Their federal civil rights case goes to trial right after the criminal trial. All of which is paid for by Texas taxpayers… not the doctor or sheriff!

  41. #41 Calli Arcale
    February 10, 2010

    Carbon Footprint Creator @ 25:

    HMMM… The last time I checked herbal supplements were not illegal and it was not illegal for a doctor to give them or suggest them to patients. I am not sure about selling them to patients. My eye doctor has sugessted Omega 3 and Lutein to me on more than one occasion. I suppose his criminal actions must be punished then? I think not. Looks like the guy who went to jail deserved it. Troublemakers always do.

    You might want to actually read the story before making that judgment. How do I know you haven’t read the story? Because the “troublemaker” has not yet gone to jail (the trial hadn’t even started at the time you posted your comment), and is a gal, not a guy.

    Lots of doctors recommend dietary supplements for a variety of reasons. Nothing illegal, unethical, or below the standard of care about that. But doctors telling ER patients to buy his own special formulas from his own business? Doctors using patient lists to create advertising mailing lists? Doctors performing surgeries which they are not trained to perform in a hospital where they do not even have surgical privileges? Something’s seriously fishy, totally apart from his penchant for non-standard therapies. It looks blatantly like a doctor who abuses his position to financially exploit his patients. He wouldn’t be the first.

    There’s nothing wrong with a doctor recommending a medication to you — unless that doctor stands to benefit financially from the recommendation. It’s as true if the doc is recommending the special supplements he himself manufactures as it is if he is recommending expensive testing performed by his own facility. This is the main reason why insurers want you to get a referral before seeing a specialist; it reduces the chances of this sort of fraud.

  42. #42 "Carbon Foot Print Creator" rebuttal
    February 10, 2010

    What an obtuse statement (an name) Carbon Foot Print Creator.
    If your doctor recommended some suppliments that’s one thing. If he just so happened to have just the right concoction avaialble right here in his right pocket.. that’s, at best.. questionable.. more likely.. a scam.. and a scam that’s Low-ness can only be outdone by that of a spiritual scam-artist.
    By the way, did you actually graduate elementary school?

  43. #43 Kevin P.
    February 10, 2010

    Lots of folks slamming the state of Texas here. Apparently it is scientific to generalize about a state of 24 million people. Those folks must belong to the tolerant and inclusive crowd who celebrate diversity.

    I have lived in Texas for nine years. Scandals like this actually come to light here and are eventually dealt with. There are many other tolerant and inclusive cities and states in America where injustices go uncorrected forever.

  44. #44 Astonished
    February 10, 2010

    Law west of the Pecos!! Where is Roy Bean when you need him?

  45. #45 William Penrose
    February 10, 2010

    Is it time to seriously consider the Texas Governor’s offer to secede from the Union? In a third world nation, cases like this won’t seem so unnatural.

  46. #46 Chris
    February 10, 2010

    Well, Kevin P., I would agree if the majority of folks were slamming Texas. But seriously I have only seen a couple of off the wall comments.

    I agree that Texas is a large and very diverse state. First off Austin has its own climate. It is funky, young and proud to be a little bit strange (lots of computer companies, three of the guys who were in my physics class work for AMD — oh, and an aside… a local film maker there was also in that physics class, the decided that Gov. Dolph Briscoe would no longer meet with high school students visiting the capital after she asked a very embarrassing question). At the JETS (Junior Engineering Technical Society) high school conference competitive tests at Texas A&M the kids from Clear Lake won everything (guess where NASA is located). My first boyfriend worked in the petroleum business in Houston.

    Even West Texas is very diverse. I have been to El Paso, and it is lovely (visiting one of my dad’s friends who was an Army officer in Fort Bliss, and later helped manage the Sun Bowl).

    Don’t mess with Texas.

    The problem is that Arafiles has messed with Texas (and definitely with Texans). The sheriff is messing with Texas (and though both nurses live in New Mexico, he has probably messed with Texans).

  47. #47 Jerjoshy
    February 11, 2010

    Why would that doctor do such cruelty to others…They must be put to jail to stop all these issues!!!

  48. #48 eppie w.
    February 11, 2010

    I use to work for a peer review organization with doctors reviewing for quality of care for Medicaid and Medicare patients. Before that I was a director of two Health Information Management departments.

    There was plenty of cover-up regarding physician malpractice in Texas with no need for a local sheriff.

    The peer review organization had a contract with the federal government and one of the mandates was to find doctors who were practicing bad medicine and bring them up before the state disciplinary board.

    Although, I do think the organization helped improve quality in hospitals because they existed and hospitals knew they were being monitored, few physicians were reprimanded. In the eight years that I worked for the organization, only 7 doctors got their license suspended or revoked. Most of them got a slap on the wrist and were required to take a few more continuing education hours.

    There was a saying among the reviewers, “To be reprimanded by the State of Texas a physician has to do more than killing one patient due to medical malpractice,he or she has to show a pattern of killing multiple patients.”

    Almost all doctors who have their licenses suspended in Texas are not due to medical malpractice but drug abuse or inappropriate conduct with patients. One hospital where I worked had a “farm” where they sent their doctors who had problems to recover from their addiction or whatever.

    I doubt it has changed much. The state medical assocation has always been politically strong.

    E.

  49. #49 Celtic Skyes
    February 11, 2010

    Verdict in – Found Not Guilty!
    http://www.cbs7.com/news/details.asp?ID=17876

  50. #50 Kevin P.
    February 11, 2010

    Yay for the jury and for the common sense of the ordinary citizens of West Texas (ahem)!

  51. #51 https://www.google.com/accounts/o8/id?id=AItOawm95p2NxQeyrpQQzuUUGyss65Z_xNDYps8
    February 12, 2010

    Having been a nurse for over 10 years, it is almost unheard of to hear of a nurse winning in this kind of a power struggle. Nursing shortage or not, hospitals virtually ALWAYS will stand behind the physician, regardless of the conduct involved. I imagine this is certainly magnified in the rural setting where physician recruitment is challenging.

    I hope these nurses find sufficient recourse, somehow.

  52. #52 Steve Bowling
    February 12, 2010

    The nurses need to sue the corrupt SOB sheriff for abusing the power of his office. Nothing like some personal liability to get his attention.

  53. #53 SHERRI BISHOP
    May 15, 2010

    YES, I have a story of my own I would like to tell about a ARLINGTON, TEXAS DOCTOR who KILLED MY SON…. PLEASE WRITE ME BACK SO I CAN TELL MT STORY TO WHOM EVER WILL LISTEN……THANK YOU

    S. BISHOP

  54. #54 SHERRI BISHOP
    May 15, 2010

    YES, I have a story of my own I would like to tell about a ARLINGTON, TEXAS DOCTOR who KILLED MY SON…. PLEASE WRITE ME BACK SO I CAN TELL MT STORY TO WHOM EVER WILL LISTEN……THANK YOU

    S. BISHOP

  55. #55 SHERRI BISHOP
    May 15, 2010

    YES, I have a story of my own I would like to tell about a ARLINGTON, TEXAS DOCTOR who KILLED MY SON…. PLEASE WRITE ME BACK SO I CAN TELL MT STORY TO WHOM EVER WILL LISTEN……THANK YOU

    S. BISHOP

  56. #56 SHERRI BISHOP
    May 15, 2010

    YES, I have a story of my own I would like to tell about a ARLINGTON, TEXAS DOCTOR who KILLED MY SON…. PLEASE WRITE ME BACK SO I CAN TELL MT STORY TO WHOM EVER WILL LISTEN……THANK YOU

    S. BISHOP

  57. #57 SHERRI BISHOP
    May 15, 2010

    YES, I have a story of my own I would like to tell about a ARLINGTON, TEXAS DOCTOR who KILLED MY SON…. PLEASE WRITE ME BACK SO I CAN TELL MT STORY TO WHOM EVER WILL LISTEN……THANK YOU

    S. BISHOP

  58. #58 SHERRI BISHOP
    May 15, 2010

    YES, I have a story of my own I would like to tell about a ARLINGTON, TEXAS DOCTOR who KILLED MY SON…. PLEASE WRITE ME BACK SO I CAN TELL MT STORY TO WHOM EVER WILL LISTEN……THANK YOU

    S. BISHOP

  59. #59 SHERRI BISHOP
    May 15, 2010

    YES, I have a story of my own I would like to tell about a ARLINGTON, TEXAS DOCTOR who KILLED MY SON…. PLEASE WRITE ME BACK SO I CAN TELL MT STORY TO WHOM EVER WILL LISTEN……THANK YOU

    S. BISHOP

  60. #60 SHERRI BISHOP
    May 15, 2010

    YES, I have a story of my own I would like to tell about a ARLINGTON, TEXAS DOCTOR who KILLED MY SON…. PLEASE WRITE ME BACK SO I CAN TELL MT STORY TO WHOM EVER WILL LISTEN……THANK YOU

    S. BISHOP

  61. #61 SHERRI BISHOP
    May 15, 2010

    YES, I have a story of my own I would like to tell about a ARLINGTON, TEXAS DOCTOR who KILLED MY SON…. PLEASE WRITE ME BACK SO I CAN TELL MT STORY TO WHOM EVER WILL LISTEN……THANK YOU

    S. BISHOP

  62. #62 Patient Records
    December 16, 2010

    Too many people get in trouble for trying to speak out on something that should be spoken out about.

The site is currently under maintenance and will be back shortly. New comments have been disabled during this time, please check back soon.