Respectful Insolence

Remember the case of the Winkler County nurses?

This is the story of two nurses who blew the whistle on a bad doctor, a quack even, in my opinion. As a result they faced the very real possibility of jail time. And not just jail time, but serious jail time, up to ten years. I first wrote about this story nearly two years ago, when I first learned of Dr. Rolando Arafiles, his good buddy (and business partner hawking supplements with him) Winkler County Sheriff Robert Roberts, and the administration of a small hospital in the middle of nowhere in west Texas.

Readers might recall that Dr. Arafiles achieved notoriety when these two brave nurses reported their concerns about Dr. Arafiles’ substandard care to the Texas Medical Board. However, it should be noted that the failure to discipline Dr. Arafiles is not simply a problem of the TMB. Remember, prior to going to the TMB, Galle and Mitchell had taken their complaint through formal channels at the 25-bed rural hospital where they worked, Winkler County Memorial Hospital. Their complaints were in essence ignored. Moreover, it’s not as though these problems were subtle. They weren’t, and they became apparent immediately after Dr. Arafiles joined the medical staff of Winkler County Memorial Hospital, as I documented. More appallingly and all too often not mentioned or barely mentioned is that Winkler County Sheriff Robert Roberts, Jr. was not only just Dr. Arafiles friend and patient, but he had been in business with Dr. Arafiles selling supplements. In fact, during crossexamination, Dr. Arafiles even described how Sheriff Roberts had sold his nutritional supplement called “Zrii,” going so far as to hold meetings at the local Pizza Hut to recruit other sellers. No wonder when it came to chasing down these nurses, Sheriff Roberts transformed himself from Barney Fife to, as I once put it, Jack Bauer on crack, from Inspector Clouseau into a veritable Sherlock Holmes. He figured out who the nurses were and brought charges of misusing official information against them. Ultimately, the charges were not pursued against one nurse (Vickilyn Galle) but were against Anne Mitchell.

The trial was a complete farce, and Mitchell was found not guilty in record time.

Unfortunately, there was no good way for Mitchell and Galle. They were out of work, and it’s not as though there were a lot of other job opportunities in that sparsely populated part of west Texas. The entire power structure of Kermit, TX and Winkler County, including Sheriff Roberts, County Attorney Scott Tidwell, and the entire administration of Winkler County Memorial Hospital arrayed against them. You’d think that this was just another story of the good ol’ boys network in a small town banding together to teach a couple of “uppity” women a lesson for daring to go against them, and you’d be right. What’s unusual about this case is that, in the end, it appears that justice will actually be done:

Jurors have convicted a West Texas sheriff of retaliating against two nurses who complained to state regulators about a physician friend.

Winkler County Sheriff Robert L. Roberts Jr. was convicted Tuesday in Midland on all six counts. He faces up to 10 years in prison when the penalty phase of the trial begins later Tuesday or Wednesday.

Roberts is accused of retaliating against the nurses after they sent an unsigned letter to the Texas Medical Board about Dr. Rolando Arafiles Jr. in 2009. The nurses, who alleged Arafiles was endangering patients, were later fired and indicted. One was acquitted and charges were dropped against the other.

Roberts, who has served as sheriff for 20 years, was convicted of retaliation and misuse of official information, both felonies, and one misdemeanor charge of official oppression.

That’s right. Sheriff Roberts is guilty. That’s guilty, guilty, guilty, guilty!

I must admit, I never expected this outcome. I really didn’t. I figured that, at the most, Mitchell and Galle might have gotten a fat settlement in a civil suit, which they would have richly deserved. Actually, they did get a decent settlement of $750,000 from the county, but that strikes me as not enough to repair the damage done. Still, it is reassuring that it looks as though the Sheriff is going to prison, hopefully for a good, long time. His friends might well follow him there, too, as they were indicted by a grand jury on the following charges:

Winkler County Attorney Scott Tidwell: third-degree felony for retaliation; third-degree felony for misuse of official information; Class A misdemeanor for official oppression. Former Winkler County Memorial Hospital Administrator Stan Wiley: third-degree felony for retaliation.

Here’s hoping Tidwell and Wiley soon find themselves wearing bright orange jumpsuits too. And Arafiles, while they’re at it.

In the meantime, if you’re interested, there are two excellent summaries of the long and winding road that is this story. First, there’s a recent segment that appeared on This American Life. Then, there’s a long and detailed telling of the story that appeared in the Texas Observer three months ago. These stories provide lots of details that even I hadn’t known about. Among some of the tidbits:

By July, Warren noticed that the new doctor had begun to “change medicines on patients who had been on thyroid meds for many years and were stable.” Worse, he was not rechecking them to make sure the new medications were working. Arafiles, as the Texas Medical Board would later find, also prescribed powerful thyroid-stimulating drugs to patients who came into the hospital with common maladies like stomach pains or sinus infections. Putting a healthy person on thyroid stimulants is dangerous, Warren says. The drugs can cause hyperthyroidism in healthy patients–unchecked, that can lead to permanent organ damage and death.

More disturbing was that Dr. Arafile’s bad doctoring led to a mass exodus of quality people from Winkler County Memorial Hospital when they saw how he was being protected:

Naomi Warren [a nurse practitioner at the hospital] says she lost hope. “They beat me down,” she says. “I realized they were on a path they didn’t intend to get off of.” She quit in February 2009, 10 months after Arafiles was hired. According to another board member, when Beckham, the board president, learned she had quit, he said, “Well, if she doesn’t like Arafiles, let her go.”

When Warren took a job down the road in Monahans, more than 600 of her loyal patients chose to drive the extra 25 miles to Monahans to see her, resulting in revenue losses for Winkler Memorial. Her departure was part of a larger exodus of hospital and clinic personnel shocked by Arafiles and the hospital’s handling of him. Dr. Khoa Pham, the hospital’s chief of staff, had been fighting with Wiley about Arafiles and left in January 2009 as his contract expired. A few months later, Debby Eggers, the nurse who worked under Arafiles, and Corina Chavez, the clinic manager, quit to join Warren in Monahans.

Eggers says she left because “I couldn’t control Dr. Arafiles. And I couldn’t sleep at night wondering, what if I didn’t catch one of his mistakes?”

And then there was the cronyism and incompetence of the legal establishment in Kermit:

Rounding out the fivesome was Scott Tidwell, Arafiles’ and Roberts’ personal attorney. He had moved to Kermit in 2008 after being convicted of running a prostitution ring out of the Healing Touch massage parlor in Odessa. The sheriff had convinced Tidwell to run for Winkler County attorney, and helped him get elected.

Somehow, it seems so appropriate, doesn’t it?

Looking back over this case, I see that, besides being a massive miscarriage of justice initially, in which the good ol’ boys in a rural town did what they thought they needed to do to protect their good buddy Dr. Arafiles from discipline for his dubious medicine, which included anti-vaccine views and hawking quack treatments for Morgellons’ disease, it’s also a reminder of the failure of state medical boards to discipline errant physicians, much as Dr. Rashid Buttar in North Carolina is another poster child for bad doctors and quacks who is more or less untouchable. True, Dr. Arafiles is facing criminal charges. However, all the discipline he got from the Texas Medical Board was a slap on the wrist. No, it wasn’t even a slap on a wrist. It was the equivalent of being told in a baby-talk voice that he was a bad, bad boy and instructed not to do it again, or I’ll get really cross. Contrary to what he richly deserved, Dr. Arafiles did not lose his medical license. Instead, he was put on probation, required to take continuing medical education classes, and fined $5,000. As Mitchell pointed out, Arafiles would probably have been fined more if he had gotten into a verbal confrontation with her and abused her verbally.

In the end, even though I’m happy to see Sheriff Roberts on his way to prison, with Scott Tidwell and Stan Wiley likely to follow him there, I’m saddened by what this incident says. What it says is that nurses should just shut up and not question the god-like prerogative of doctors and that they are completely expendable, far more so than doctors. Unfortunately, the only way the citizens of Texas will be safe from Dr. Arafiles’ incompetence and quackery will be if he is convicted when his case goes to trial.

Comments

  1. #1 SocraticGadfly
    June 16, 2011

    Here’s the story from a newspaper of record in the area, not the AP story, Orac:

    http://www.oaoa.com/articles/roberts-66909-county-arguments.html

  2. #2 lilady
    June 16, 2011

    Well there’s some good news and some bad news with this story. Finally, this quack is brought to justice but why did it take so long?

    It is very telling that not only did the sheriff misuse his office, but so did the County Attorney (who also has a history of pimping for prostitutes out of the (ahem) massage parlor). And, what about the townies who shunned the nurses who blew the whistle…I suspect Doctor Quack was “prescribing” some major pain “meds” and they didn’t want their dealer to go out of business.

    The compensation the nurses received for this injustice can never compensate them for the conspiracy to convict them for blowing the whistle on an incompetent, criminally negligent quack.

  3. #3 Pinko Punko
    June 16, 2011

    Orac, SG’s link above (the comments on that story) suggest that Roberts won’t get jail time. He waived his right to appeal and be sentenced by the judge- the judge then took the prosecutor’s recommendation for probation. I’m looking for the details, but looks like no prison.

  4. #4 Matthew Cline
    June 16, 2011

    That’s right. Sheriff Roberts is guilty. That’s guilty, guilty, guilty, guilty!

    Yayyyyy!

    Orac, SG’s link above (the comments on that story) suggest that Roberts won’t get jail time.

    Booooo!

  5. #5 genewitch
    June 16, 2011

    The guy conspired to deprive a citizen of this country of freedom, and he’s getting probation?

    It seems like a conflict of interest to allow the prosecutor and judge to set the sentence here, doesn’t it? Wasn’t the prosecutor also indicted?

  6. #6 af
    June 16, 2011

    afAF

  7. #7 Kitto
    June 16, 2011

    I hope he goes to prison. It’s great to hear some justice was served with the guilty verdict.

  8. #8 Lawrence
    June 16, 2011

    Much like their treatment of celebrities, Courts seem very reluctant to put public officials in jail (at least for less than major offenses) – and if he had an even half-way decent lawyer, any plea or penalty-phase negotiations are going to start with probation.

  9. #9 MikeMa
    June 16, 2011

    The conviction should keep the slimy sheriff from working in law enforcement one hopes. Still, he probably maintains that supplement business bilking people out of cash for crap.

  10. #10 DLC
    June 16, 2011

    Sometimes there really is justice.
    thanks for passing the word along, Orac.

  11. #11 Poodle Stomper
    June 16, 2011

    Sigh. Truly a disgusting story (in the beginning, at least). I’m glad to see they got caught, though I’d much like to have seen them get larger sentences. 20-to-life for being a dick to nurses that were only looking out for their patients should start things off right.

  12. #12 ebohlman
    June 16, 2011

    Roberts will serve jail time, although only 100 days. He was also fined $5000, will be on probation for 4 years, has lost his job as Sheriff and has surrendered his Texas peace office license.

    Not really enough, but better than nothing.

  13. #13 mattand08
    June 16, 2011

    Nice to see there’s some justice in the world.

  14. #14 cb
    June 16, 2011

    I am glad a sheriff is actually being punished for abusing the law, it’s about time, a lot of sheriffs act like kings of their little fiefdoms.

    Now, the only real thing left to do is for the owners of the hospital to go after the board members who covered for him. After all, if the hospital is losing patients, and reputation, and money, the shareholders should be pretty pissed, especially since the board is supposed to represent them. I hope they do, since they really need to be punished much more than the taxpayers of the county do (which is where the $750K will come from, unfortunately).

  15. #15 Luna_the_cat
    June 16, 2011

    Having read the story at the Texas Observer, it ends on a profoundly depressing note.

    The hospital’s new compliance officer, the one who replaced Mitchell, is Peggy Armstrong. When I asked her about Arafiles, she said, “He’s a great doctor. Great. You shouldn’t believe the bad press.”

    The expectation is, apparently, that the quack doctor who is endangering people’s lives will continue to practice and is still being supported by the hospital, while the nurses who were trying to protect patients cannot find work again.

  16. #16 Dangerous Bacon
    June 16, 2011

    “More disturbing was that Dr. Arafile’s bad doctoring led to a mass exodus of quality people from Winkler County Memorial Hospital when they saw how he was being protected:”

    “Naomi Warren [a nurse practitioner at the hospital] says she lost hope. “They beat me down,” she says. “I realized they were on a path they didn’t intend to get off of.” She quit in February 2009…When Warren took a job down the road in Monahans, more than 600 of her loyal patients chose to drive the extra 25 miles to Monahans to see her, resulting in revenue losses for Winkler Memorial.”

    This, the loss of other key personnel and the damage in reputation to the hospital point up the other major victims in this case – the people of a poor rural county who’ve had to pay out legal settlement costs and face a financial threat to their community hospital.

  17. #17 JayK
    June 16, 2011

    I don’t see any mention of insurance fraud through misdiagnoses. I wonder if the insurance companies are looking into it, seems like they could easily sue the hospital into the ground.

  18. #18 Eric Lund
    June 16, 2011

    In the “hoist on their own petard” department, I note that Roberts was convicted, and Tidwell indicted, for misuse of official information–the same statute under which they charged Galle and Mitchell.

    Yes, Roberts and Tidwell should both spend some time in Stripe City.

  19. Though I would prefer a sentence more severe than 100 days and 4 years probation, a felony conviction on your record is nothing to sneeze at.

    He’ll never be able to be law enforcement officer again, should be unable to posses or purchase firearms (a big deal for many Texans), and would have difficulty applying for most jobs.

  20. #20 BamBam
    June 16, 2011

    Wow!! Unbeilievable!! It’s amazing how a bunch of Nuerotic blowhards can sit on their computers all day and take jabs at someone when they are down. I agree that Sheriff Roberts made a huge mistake. But, if you look at his record of over 30 years of serving in law enforcement he has done a lot of good things for Winkler County. Yes the doctor should have to surrender his license, (if a medical review investigates, and demands), and yes Tidwell should stand trial as well, but I don’t beleive that jail time for the Sheriff is warrented. It’s humiliating and humbling enough for him to have to surrender his law enforcement license, but jail time is just over the top. For all of you name callers and haters, you need to get educated and informed on all the facts and the situation, not just the hear, say. As for Orac, sounds like Liberal vile to me.

  21. #21 Vicki
    June 16, 2011

    BamBam:

    So the only penalty you consider appropriate for trying to get innocent people locked up is to be stopped from doing it again? Precisely because sheriffs have that power, they have to be held to a higher standard. That means they’re supposed to be committed to justice and the rule of law, not that the penalty for what would be called kidnapping if you or I did it—removing innocent people from their homes and holding them prisoner—should be merely losing their jobs.

    Humiliation is not a sufficient penalty for what he did: we’re not talking about an extramarital affair, we’re talking about misusing his office in ways that harmed innocent people.

  22. #22 Rory
    June 16, 2011

    Go fuck yourself, BamBam. The asshole sheriff went after two nurses who were looking out for their patients. He misused his position to find them, and he got his crony in the DA’s office to prosecute them for a crime that literally wasn’t even a crime. they could have been fined thousands or spent years in prison if they’d succeeded. Sheriff Asshole should get thrown into prison with all the lowlifes he’s busted in his 30 years so that they can pass his doughy ass around like a party favor.

  23. #23 Dave
    June 16, 2011

    Rounding out the fivesome was Scott Tidwell, Arafiles’ and Roberts’ personal attorney. He had moved to Kermit in 2008 after being convicted of running a prostitution ring out of the Healing Touch massage parlor in Odessa.

    Apparently, it wasnt only the Texas Medical Board that fell down on the job. Why wasnt Tidwell disbarred after running a prostitution ring?

  24. #24 Denice Walter
    June 16, 2011

    A few notes on Texas:

    According to woo-meister Null: Texas is a great state for re-location by his ilk ( non-reality-based providers) because it has *less* legislation about these issues- i.e. it is more “health-freedom” friendly, unlike the worst “offenders”- NY, NJ, and CA- which have way too many pesky laws about health care and supervision of its practitioners. Those East Coast fascists would like to vaccinate health care workers against the flu! Plus, both they and the West Coast socialists tax too much! The horror !

    Texas’ current governor, Perry, has threatened secession in response to Obama’s Healthcare proposals… and other things.

    Texas is the home of Libertarian Rep. Ron Paul, fave of health freedom advocates, like the aformentioned idiot and his *compadre*, Mike Adams. Rand Paul grew up there.

    Andy Wakefield currently lives is Austin, TX, following his departure from the UK: he probably wanted to escape the dampness there. Yeah, that’s what it was.

  25. It was not a huge mistake. A huge mistake would be something like making a procedural error that let a criminal go free, or missing evidence, leading to a false conviction.

    This was a huge, criminal abuse of power. It was a betrayal of the public trust, his civic duty, and his oath to uphold the law. This can only be considered a mistake in the sense that the choice to commit any crime is a mistake, and committing a huge crime would be a huge mistake.

    If the sheriff conspired with the doctor and others in his criminal abuse of power for the protection of profit in his side business, then that group of conspirators could be considered a racket, and in violation of the RICO act, a federal crime.

  26. #26 Sastra
    June 16, 2011

    I thought Brave Maverick Doctors like Arafiles were supposed to be set upon and oppressed by The System. Somehow, this network of good-ol’-boy cronyism going on a lawbreaking witchhunt against nurses who were just nobly following their conscience doesn’t seem to fit the persecution scenario. It’s backwards. However do the alties spin it?

  27. #27 The Panic Man
    June 16, 2011

    I just heard about this case a couple weeks back. It was in a segment of This American Life.

    Good to see there’s some small justice being meted out over this. Now if only these scumbags could be locked away for life, that’d be better.

    Rory @#23: Jokes about prison rape aren’t cool. Don’t do it again.

  28. #28 ArtK
    June 16, 2011

    Sastra,

    It’s easy, really. Those weren’t nurses “just nobly following their conscience,” they were tools of the oppressive system.

  29. #29 Anton P. Nym
    June 16, 2011

    BamBam, what you failed to consider is this damning aspect of the incident (quoted from Orac’s item):

    Winkler County Sheriff Robert Roberts, Jr. was not only just Dr. Arafiles friend and patient, but he had been in business with Dr. Arafiles selling supplements.

    Sheriff Roberts acted as he did to protect a business partner, and arguably to protect his side business that was profiting heavily from the doctor’s conduct these nurses reported as unprofessional and unsafe. And Roberts acted in a manner that was at least reckless, arguably malicious. That’s not a mistake; that’s corruption and abuse of power.

    — Steve

  30. #30 Yojimbo
    June 16, 2011

    BamBam’s logic sounds a bit like saying they should go easy on John Wilkes Booth because he played Hamlet well.

  31. #31 Matthew Cline
    June 16, 2011

    The hospital’s new compliance officer, the one who replaced Mitchell, is Peggy Armstrong. When I asked her about Arafiles, she said, “He’s a great doctor. Great. You shouldn’t believe the bad press.”

    Yeah, him getting his buddy the sheriff to arrest two nurses for things that weren’t actually crimes? Just lies by the press.

    @cg:

    Now, the only real thing left to do is for the owners of the hospital to go after the board members who covered for him. After all, if the hospital is losing patients, and reputation, and money, the shareholders should be pretty pissed, especially since the board is supposed to represent them.

    My cynical side thinks it more likely that they’ll blame all their problems on the nurses.

    @Rory:

    Sheriff Asshole should get thrown into prison with all the lowlifes he’s busted in his 30 years so that they can pass his doughy ass around like a party favor.

    Prison rape isn’t anything to joke about, and isn’t something that should be used to met out justice.

  32. #32 Narad
    June 16, 2011

    I have to say that this is the last place I would have expected to find a link to Al Freaking Yellon.

  33. #33 Svlad Cjelli
    June 17, 2011

    “This was a huge, criminal abuse of power. It was a betrayal of the public trust, his civic duty, and his oath to uphold the law. This can only be considered a mistake in the sense that the choice to commit any crime is a mistake, and committing a huge crime would be a huge mistake.”

    Wonder if that should be considered treason. Maybe not, but either way I’d like to see more judges who don’t go easy on officials.

  34. #34 Venna
    June 17, 2011

    I abhor people who abuse their station and believe they are above the law (e.g. most politicians, some doctors, some, for lack of a better term, clergymen). I’m glad that these guys will finally get that magic carpet pulled out from under them and realize they’ve gone too high to fall and not get hurt (at least their careers.)

    This reminds me of a situation I learned about late last year about a young woman studying early childhood special education so she can work specifically with children with autism. She has Asperger’s herself so she felt she had an inside look into the world of the autistic children that other people lacked.

    She was in her final year, which included a stint as a student teacher. She was placed in a class of preschool children, all of them under 5, all of them having some form of ASD, most of them non verbal. She witnessed the teacher verbally and physically abuse these children on multiple occasions. She notified the principle at the school and what did she get for her troubles?

    She was actually pulled out of the student teacher program. There was an ‘investigation’ into the allegations and nothing ever came of it and the teacher is still there, tormenting those children who can’t tell anyone about it. She was bad mouthed by the school in letters to the parents’ of the children involved, saying she was mentally unstable because of her ASD. She was treated badly also by people, both students and faculty alike, at her school, and because she wasn’t placed again in another student teacher position, wasn’t able to complete the requirements of the course and wasn’t able to graduate with the rest of her class-men when she should have.

    If you want to hear the story from her mouth, she’s on YouTube, her channel is Motleyprism. I don’t know if there’s anything we can do about it, but I know she could use some support and to know people believe her.

  35. #35 Marilyn Mann
    June 18, 2011

    Based on other sources on the web, it appears that Tidwell was not running the Healing Touch prostitution operation; he was a client, and he also brought a prostitute to a hotel for parties. He was charged with a misdemeanor. A misdemeanor might not be enough to get him disbarred.

  36. #36 David N. Andrews M. Ed., C. P. S. E.
    June 20, 2011

    “She notified the principle at the school and what did she get for her troubles?

    She was actually pulled out of the student teacher program.”

    I know of the girl you’re talking about. Brave though she was, it cost her that opportunity. Not that I think she was stupid; she wasn’t. She became yet another victim of a sick organisational culture that has reinforced that sickness of practice within itself. FWIW, I believe that lass.

    A similar thing happened in a care hospital in the UK; and that situation eventually found its way onto a tv documentary – done under-cover – that ended up with masses of shit on the faces of a number of high-up pieces of shit … all of whom knew what was going on, because they’d all been told about it by a (now) former worker there. Yep. He’d been axed from post for having done so.

    Sick organisational cultures. And nasty bastards who create and maintain them.

  37. #37 mikerattlesnake
    June 22, 2011

    Aw, isn’t Bambam the good little authoritarian. Cops can’t be bad people, only criminals can! And criminals are easy to spot because they have funny sounding names and unfamiliar skin tone! This sherriff probably went to church and EVERYTHING. Plus, the people who accused him are women, and lord knows they can’t be trusted. Damn those vile liberals for limiting the rights and freedoms of a GOOD AMERICAN! How can we be hard on crime if we don’t have people like him in law enforcement? To catch a criminal, you have to think like a criminal, and I certainly don’t want someone with respect for the human rights of a criminal to be bustin’ folks. No sir, I want someone who will stomp some ass and break some laws!

  38. #38 Boat
    October 25, 2011

    I first heard this story on ‘This American Life’ and I was convinced this was a fictitious story, like a much-less-tumultuous ‘War of the Worlds.’ I am amazed that the two nurses got such a small package from the county, but the old boy’s club probably runs that operation, too. Kermit, TX sounds like a place you only ever see in scary movies.

  39. #39 ASSE
    November 15, 2011

    Generally I do not post on blogs, but I would like to say that this post really forced me to do so. Really nice post!