Fired Hopkins doctor seeks $24M

[sirus_virus]

Do these physicians have insurance to cover payment if they loose the lawsuit? How is the chief resident going to pay if he loses?

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[sirus_virus]

That's why I am reserving judgment until trial time. I hope he doesn't settle because I want all the dirty laundry aired. If Hopkins was at fault, I want them pay and pay dearly so that it sets a precedent all residency programs. Don't look at your residents like slave labor. Don't even think about retaliating against them if they speak the truth.

Retaliation firings are among the easiest lawsuits to win, mainly because every jury member with a job of their own is disgusted from the begining to the end of the trial. What is more interesting is that he is going after individual pockets of the physicians involved. The law firm in question is pretty sharp too, so I am thinking Hopkins might be retiring this kid early.

 

[orbitsurgMD]

Retaliation firings are among the easiest lawsuits to win, mainly because every jury member with a job of their own is disgusted from the begining to the end of the trial. What is more interesting is that he is going after individual pockets of the physicians involved. The law firm in question is pretty sharp too, so I am thinking Hopkins might be retiring this kid early.

No doubt. There is no way they can look even halfway good at trial. Big, arrogant, self-important JHU in a Baltimore City courtroom? That is their worst nightmare. They'll settle for big money most of all to seal the non-disclosure agreement.

 

[indo]

Moral of the story:

It's all about drawing the line EARLY ON.

If someone asks or demands something of you that is unfair or unjust, you REFUSE immediately. Apologizing or conceding is asking for trouble later, when after you have bent over backwards for those bullies multiple times you gain the confidence to stand up - only by then those a-holes are used to you being a doormat, and know that being a doormat is your natural function, so they'll beat you back down to your place.

Assert your dominance ASAP.

My guess is that Dr.Serrano did not draw the line at his program. He worked like a slave, thinking that this would impress his superiors. He was then given more work because he was "the slave". After he got fed up and reported his program, said program retaliated because slaves are not expected to stand up for themselves.

Indeed. A wise chief resident once said, "after you're done being a student, you don't want the reputation of being flexible."

 

[dragonfly99]

disagree with indo...
Refusing to do stuff and disagreeing with attendings or nurses is an easy way to get yourself a bad reputation, and perhaps held back or put on probation, at many programs. It may depend on the culture of your particular program, but in general I've found that refusing to do stuff is not really feasible a lot of the time when you are a trainee. It DOES dependon the program though...my attendings at my current fellowship really defend me and try to protect my learning time and don't let other attendings take advantage of me, but @my residency it was strictly a "do or die" type situation where if you ticked off some attending or nurse then 99% of the time the resident would be blamed no matter who was actually in the wrong.

 

[toby67a9]

Interesting, if he was mentally then I think it was up to his program to try to help him as best they could to protect both patients and student. Residency is supposed to be a training period.

Goes to show all of the BS about doctors being caring, speaking from experience everyone says "mental illness and depression is one of the most treatable deseases, please get help..." blah blah blah, never heard so much BS. Speaking to several friends and family that have suffered through this terrible illness their advice is... keep it quiet.

Once employers know they will find a reason to dump you, all of that caring crap is just so they sound politically correct and caring. Speaking from personal experience of someone close to me, they suffered depression while in residency, got out got treatment and went back several months later. 5 months into their 4th year they were terminated, no specifics no mistakes just " you are not a good fit for our program"

My advice if you are suffering from depression, don't let your PD know, get family help and cover your butt. Most PDs don't give a rats behind about you or your medical conditions.

Sorry to sound so bitter but where my family is concerned I have no mercy for unfair treatment.


IFF they terminated him wrongfully I hope he gets millions from them and they are forced to fire that PD and all of the participating attendings. Good riddance to all of them.

 

[dragonfly99]

Agree w/ the above comments predicting an out of court settlement.
I doubt that JHU will let this go to trial, as they won't want their dirty laundry to be aired...it would be worth several million to them if they could avoid that. The resident may be willing to settle since there was probably something on his end that was suboptimal (either anger management issues, maybe some burnout leading to less-than-great clinical performance, or maybe he ended up not being a good fit for a surgical residency). I'll bet that a lot of the firing had to do with him being too independent and not "staying in his place" though; JHU is kind of like a couple of the places I have trained...rigorous training and high clinical standards and known for good patient care, but also old-school and from what I have heard not very tolerant of any type of disagreement or trainees who won't stay in their traditional "place".

 

[Apollyon]

rigorous training and high clinical standards and known for good patient care, but also old-school and from what I have heard not very tolerant of any type of disagreement or trainees who won't stay in their traditional "place".

You've described Duke to a "T", but, for some reason, Duke residents don't sue them, and, even with work-hour violations STILL occurring, and the ACGME stepping in back in 2002, there's no publicity.

There's something to the JHU mentality. I do not know that "thing" is, though.

 

[LADoc00]

Accusing a possible whistleblower of being mentally ill IN PUBLIC is legal lunacy with what sounds like no evidence/actual diagnosis (and even if he did have a Dx you have some serious ethical lapses in releasing that info).

That in and of itself is so egregious a personal smear that it could be a career-ender for these women.

 

[LADoc00]

Do these physicians have insurance to cover payment if they loose the lawsuit? How is the chief resident going to pay if he loses?

Malpractice specifically does not cover a civil suit of this type. JHU is likely self-insured anyway. Regardless, if the ex-resident wins JHU might have pay as well as the personal estate of the attendings...ouch.

 

[Taurus]

This isn't the first time programs have gone on a smear campaign against students. Fortunately, the courts are a leveling field and students have prevailed.

Expelled dental student awarded $1.7 million in lawsuit against 'U' [University of Michigan]

By: Lindy Stevens
Daily Staff Reporter
Published December 2nd, 2008

Former School of Dentistry student Alissa Zwick was awarded $1.72 million in a lawsuit with the University yesterday.

Former School of Dentistry student Alissa Zwick was awarded $1.72 million in a lawsuit with the University yesterday.

Claiming she was forced to leave the Dental School without cause in 2005, Zwick filed the suit in May 2006 after Marilyn Lantz, associate dean of the Dental School, and three instructors claimed she was unfit to practice dentistry.

During the 13-day federal trial in Detroit, Zwick's attorney, Deborah Gordon, presented evidence that Lantz encouraged dental school faculty to write letters outlining their concerns about Zwick, which led to her dismissal.

Among the concerns cited by the faculty members were tantrums, behavior problems and poor performance in clinical classes. Zwick was officially dismissed during her third year at the school in June 2005.

According to court documents, Zwick claimed she was "retaliated against" for exercising her First Amendment rights and also alleged that her dismissal violated due process of law.

Zwick did not immediately return calls for comment Tuesday evening.

Although students recommended for dismissal from the school are subject to an appeal process, Gordon said the decision was unfair.

"Once you're admitted to a public school, you have a property interest," Gordon told The Associated Press yesterday. "You can't be dismissed without due process. The jury found the decision was not careful or deliberate."

Zwick claimed the lawsuit stemmed from an incident involving two faculty members who fought her request to take exams in a separate setting to accommodate her attention deficit disorder.

According to the lawsuit, Lantz forced the two involved faculty members to resign and used the incident to pursue Zwick's dismissal.

In her case, Zwick also cited breach of contract, defamation and "infliction of emotional distress," by Lantz and the other faculty members involved in the suit.

The University will likely pay $1 million in punitive damages, even though Lantz was listed in the suit as the primary defendant.

Lantz declined to comment on the lawsuit when reached by phone yesterday evening.

In a written statement to The Associated Press yesterday, University spokeswoman Kelly Cunningham defended the School of Dentistry's decision to dismiss Zwick.

"The university has a responsibility to exercise careful and deliberate judgment about who should be permitted to graduate from its professional schools and practice in the health care professions," Cunningham said.

"It is essential that we maintain control over academic decision-making and we stand firm in that position," she added.

Gordon and attorneys for Lantz and the University could not be reached for comment late yesterday evening.

Zwick, now 30, is currently enrolled at Eastern Michigan University, pursuing a master's degree in speech pathology. Before starting at the School of Dentistry at the University of Michigan, Zwick was accepted to eight other dental schools. After her dismissal from the University, she was denied acceptance to other dental programs.​

 

[doctorsherlock]

[QUOTE: I'll bet that a lot of the firing had to do with him being too independent and not "staying in his place" though; JHU is kind of like a couple of the places I have trained...rigorous training and high clinical standards and known for good patient care, but also old-school and from what I have heard not very tolerant of any type of disagreement or trainees who won't stay in their traditional "place".[/QUOTE]

Students, interns, residents beware. Go to work with a smile. No matter what befalls you. Keep your mouth shut, tighten your belt, and live to fight another day.

This is the most you can hope for. Until you are done. Your medical degree is worthless, otherwise. Your superiors know it.

These cases create the impetus for change. But they also create scapegoats. Even if this guy wins, he is likely to lose. His career may be over for good.

Bankers who sue Wall Street are never hired again. But bankers go on banking. They launch businesses. They invest. Doctors are not bankers. This guy cannot operate without completing residency. Tragic for someone so talented. He would not have gotten this far without loving the work.

Change only occurs at the top. So get yourself to the top. Until then, keep your mouth shut. At least in the face of the despots.

Who are the despots? Anyone above you. No matter how nice they might seem.

However, do not be meek. You can act behind the scenes. You must. Broadcast news on SDN. Disseminate information. Expose abusers. By name.

Just remain invisible.

 

[DocHolliday01]

I usually post under another SN, but for the sake of anonymity I am using a different account. I agree with the other posters who support change and adherence to policies in resident training, and for protection of those who are brave enough to blow the whistle. However, before everyone lambastes Hopkins for firing this guy, keep in mind that you only have one half of the story, and a whole lot of fine-tuning by top-notch attorneys. Naturally, they are painting a worst-possible-case-ever scenario, and portraying this resident as a victim of a cruel and malicious system. That's what lawyers are paid to do. And they have done their job well, gauging from the responses on this thread. Those of you who are getting fired up about resident abuse are certainly coming from a good place, but you may be misled about the actual reason for termination (spun nicely by the lawyers to do just that - get you pissed off at Hopkins for an unrelated reason).

For the record, I have worked with this particular resident while taking call. There were certain sentiments reflected by some of his colleages, which might lead one to believe that this particular resident had been under scrutiny by his program for some time prior to his termination - which some felt was warranted. I know nothing of this guy outside of a few encounters - I am only familiar with the opinion of some of his peers. And, of course, someone's demeanor in the workplace is no excuse for a program to fabricate stories about mental illness or other credentials. But don't jump the gun before you hear both sides of the story.

 

[doctorsherlock]

Agreed. Moderation is key. In action and thought.

Especially when lacking information. And we always lack information. Nobody is omniscient.

But abuse is hardly an anomaly. Neither is injustice. We all know what roams hospital halls. Some hospitals more than others.

Not everyone is malignant. But the point is you cannot take chances. You just never know. Better to play it safe.

Have a drink. Grab some Prozac. Call your mom. Whatever you do, smile.

Then post on a public forum. Under your fourth or fifth alias.

 

[dragonfly99]

LOL at Drsherlock.
I agree.
Trust nobody but your mama and your bff...don't vent to residency colleagues or your superiors. And don't complain.

Good points made above as well...we surely don't have all the facts. I'm sure this resident did SOMETHING that really ticked some people off. Probably more than a single something. I guess the question in my mind is did JHU really take somebody and train him for 2-3 years in their surgical program, and then find out he wasn't trainable. Really? It's not that easy to get into med school...and then it's not that easy to do well enough to get a surgical residency...and it's definitely not easy to do well enough to get a surgical residency at JHU...and it's not that easy to be smart enough and have enough of a work ethic to make it through a surgical internship at a place like JHU...was he really that dysfunctional and incompetent that they couldn't figure out a way to train him? Picking residents is sort of like getting married...at least temporarily...the trainees sacrifice a lot and give up a lot to be "Matched" and train in a program. The programs have made a certain commitment as well. It's going to be really interesting to see what, if any, details come out r.e. this case. Maybe I shouldn't be so curious, but I am.

 

[Taurus]

Good points made above as well...we surely don't have all the facts. I'm sure this resident did SOMETHING that really ticked some people off. Probably more than a single something. I guess the question in my mind is did JHU really take somebody and train him for 2-3 years in their surgical program, and then find out he wasn't trainable. Really? It's not that easy to get into med school...and then it's not that easy to do well enough to get a surgical residency...and it's definitely not easy to do well enough to get a surgical residency at JHU...and it's not that easy to be smart enough and have enough of a work ethic to make it through a surgical internship at a place like JHU...was he really that dysfunctional and incompetent that they couldn't figure out a way to train him? Picking residents is sort of like getting married...at least temporarily...the trainees sacrifice a lot and give up a lot to be "Matched" and train in a program. The programs have made a certain commitment as well. It's going to be really interesting to see what, if any, details come out r.e. this case. Maybe I shouldn't be so curious, but I am.

I agree. It is very suspicious to hear that it took JHU 3 years into his residency training to figure out he was incompetent, especially when he was a star in his first 2 years. It's more likely he pissed off somebody important and they whacked him off for it.

There's more to the story and I hope it gets aired out at trial if there is one.

 

[latinomd]

The lawsuit will take some time. In the mean time several of us California Latino concerned physician have found a surgical residency for Dr. Serrano.

Unfortunately his attorney's are unwilling to communicate this information to Oscar.

If any of you can contact or know Oscar, please have him send me an email at [email protected]

Thanks- Bob

 

[Sinfekl]

SDN can be a weird, weird place.

 

[SocialistMD]

SDN can be a weird, weird place.

Your name is misspelled; there are two "I's."

 

[leorl]

That's why I am reserving judgment until trial time. I hope he doesn't settle because I want all the dirty laundry aired. If Hopkins was at fault, I want them pay and pay dearly so that it sets a precedent all residency programs. Don't look at your residents like slave labor. Don't even think about retaliating against them if they speak the truth.

Is there any place in the world where residents feel they are not treated like slave labor? It's the fundamental way that medicine has operated and been passed down for decades. Even in programs that do adhere to work hours (ie. EM), there is always a resentment for being treated like slave labor. But if you tell the RRC this, then it's punishment back on the residents as they may not graduate if their program becomes dis-accredited . It's like this whole cycle of malcontent.

 

[Hockeyguy]

Just pure speculation on my point but this screams of substance abuse.

 

[Random]

Just pure speculation on my point but this screams of substance abuse.

That's quite an insinuation to be making absent facts. As DocHolliday01 said several weeks ago, we do only have half of the story. We shouldn't be trying to fill in the rest with complete rumor and innuendo.

 

[Sinfekl]

Your name is misspelled; there are two "I's."

On the contrary, we recently discovered a novel epitope that induced...

J/K Yes, I know. I made the mistake when I signed up and once I noticed never bothered to fix. Thanks for the help, though. Can you go back and change your username anyway?

 

[filter07]

update on serrano case, posted on the surgery forum

http://browngold.com/news/physician...r_lawsuit_against_johns_hopkins_complaint.pdf

summary:
serrano was a stud other than crap ABSITE that other hopkins people had too
he was in his research years, working on getting a phd
he was suspected of sending in an anonymous tip to the ACGME after having voiced his opposition to coached responses in the ACGME survey
the powers to be fired him, had him fired from moonlighting, and prevented him from working in another lab
their justification was poor absite and mock oral exam performance, which is pretty lame IMO considering he was in his research years
they forced him to seek psychiatric evaluation and told people he was mentally ill even though the psychiatrist said he was fine

prediction: hopkins is hosed

 

[Apollyon]

Dude should have come to Duke.

Having said that, reading that complaint (at least the first part, laying out the facts of his education), could JHU picked a worse case person to fire? The guy is made of gold with silver in his veins. If my information was changed out with his, it would be a slam-dunk. Mine would still look like I was the tool I am, even with whitewashing.

Bad move on one of the administrator's part (I don't recall if it was the PD) was sending out an email stating no negatives to the ACGME. If that is accurate, and is produced at trial, that doesn't look good.

 

[JackADeli]

Not sure if folks have seen this document.

it is an interesting read:

http://browngold.com/news/physician_files_multimillion_dollar_lawsuit_against_johns_hopkins_complaint.pdf

...

JAD

 

[ShyRem]

There are always three sides to every story. Plaintiff, defendant, and the real truth. Lawyers are paid to make the jury believe their side and not the other side. Whoever has the better lawyer wins.

I predict Hopkins will settle and the details will be sealed (like most lawsuits these days).

 

[unimaginative]

I predict Hopkins will settle and the details will be sealed (like most lawsuits these days).

I am not sure about that one. Even knowing the little that we do unless there is something so outrageously egregious that it would offend Charlie Manson his case is solid and all the parties involved knows it.

That said everyone knows that Hopkins will likely pay up the question is whether the plantiff wants to get his reputation back. I think a lot of you would have a hard time working that hard and having it all ripped away from you and being totally degraded in such a public manner. He seems to be in a position to demand a refund on his reputation as well as a buttload of $. I see a few possibilities.

1. Hopkins lawyers agree to settle but demand non-disclosure, plantiff too proud to not have everyone know the truth goes to trial and he wins $ and gets to see them totally shat on.

2. Hopkins pays and agrees to in some way admit some serious wrong doing, major letter of apology stating he was wrongly fired, false smear campaign etc., may even include firing the other plantiffs. It would be hard to justify keeping the PD especially if they just cost the hospital 24 million or whatever.

A few questions for the group or someone who knows something, i.e. not me?

1. Why isn't he suing the NIH specifically outside of the director if the T32 grant? It seems suing the NIH is a slick move since if his recipet of his salary connects in some manner albeit maybe weakly as a federal employee then I imagine the federal government has fairly rigorous standards for firing someone with many more safeguards and protection?
2. What is the connection to being a federal employee while a clinical resident since so much of the salary is paid by medicare?
3. Has anyone ever heard of a resident bringing a whistleblower case against their hospital/program. Some of you probably know about the UW case from the 90s. http://www.phillipsandcohen.com/CM/NewsSettlements/university.asp. Basically someone in the billing dept, brought a whistle blower case and walked away with 15% of the 35 milliion settlement. The majority of the fraud that UW was comitting amounted to billing medicare and medicaid for surgeries performed by residents. My guess is this case was instrumental in getting people to add that ending line into the OP notes "...I was present and particpated in the entirety of the case".
-Un

 

[unimaginative]

I predict Hopkins will settle and the details will be sealed (like most lawsuits these days).

I am not sure about that one. Even knowing the little that we do unless there is something so outrageously egregious that it would offend Charlie Manson his case is solid and all the parties involved knows it.

That said everyone knows that Hopkins will likely pay up the question is whether the plantiff wants to get his reputation back. I think a lot of you would have a hard time working that hard and having it all ripped away from you and being totally degraded in such a public manner. He seems to be in a position to demand a refund on his reputation as a $. I see a few possibilities.

1. Hopkins lawyers agree to settle but demand non-disclosure, plantiff too proud to not have everyone know the truth goes to trial and he wins $ and gets to see them totally humilated.

2. Hopkins pays and agrees to in some way admit some serious wrong doing, major letter of apology stating he was wrongly fired, false smear campaign etc., may even include firing the other plantiffs. It would be hard to justify keeping the PD especially if they just cost the hospital 24 million or whatever.

A few questions for the group or someone who knows something, i.e. not me?

1. Why isn't he suing the NIH specifically outside of the director if the T32 grant? It seems suing the NIH is a slick move since if his recipet of his salary connects in some manner albeit maybe weakly as a federal employee then I imagine the federal government has fairly rigorous standards for firing someone with many more safeguards and protection?
2. What is the connection to being a federal employee while a clinical resident since so much of the salary is paid by medicare?
3. Has anyone ever heard of a resident or medical student brining a whistleblower case against their hospital/program. Some of you probably know about the UW case from the 90s. http://www.phillipsandcohen.com/CM/NewsSettlements/university.asp. Basically someone in the billing dept, brought a whistle blower case and walked away with 15% of the 35 milliion settlement. The majority of the fraud that UW was comitting amounting to billing medicare and medicaid for surgeries performed by residents. My guess is this case was instrumental in getting people to add that ending line into the OP notes "...I was present and particpated in the entirety of the case".


-Un

 

[StIGMA]

Here is a shorter version:

http://browngold.com/news/physician_files_multimillion_dollar_lawsuit_against_johns_hopkins.pdf

From the summary:

The Complaint contains the following legal claims and claims for damages: Breach of Contract ($750,000 compensatory); Wrongful Termination ($750,000 compensatory; $3,000,000 punitive);Tortious Interference with Business Relations (two counts, $750,000 compensatory; $3,000,000
punitive each); Defamation (four counts, $10,000,000 compensatory; $10,000,000 punitive each); and Invasion of Privacy (two counts, $10,000,000 compensatory; $10,000,000 punitive each).

Looks like more than 24M.

 

[JackADeli]

...I think a lot of you would have a hard time working that hard and having it all ripped away from you and being totally degraded in such a public manner...

2. Hopkins pays and agrees to in some way admit some serious wrong doing, major letter of apology stating he was wrongly fired, false smear campaign etc., may even include firing the other plantiffs. It would be hard to justify keeping the PD especially if they just cost the hospital 24 million or whatever.

...1. Why isn't he suing the NIH specifically outside of the director if the T32 grant? It seems suing the NIH is a slick move since ...

3. Has anyone ever heard of a resident or medical student brining a whistleblower case against their hospital/program. ....

I am by no means an expert in any of this but here goes my thoughts:

First, presuming a significant amount of what is described in the link I posted is true, I concur; too much effort to allow such a character assassination. I would not settle. I would push right to the jury for redemption. Or, I would accept sttelemet for full dollar amount with strong and direct letters, with no hedging, that state unequivically I was right, they were wrong. Further, I would never sign confidential until such time as a secret deal was pushing a billion (with a "B"). If settling, I would demand PGY4 year placement in major name program, if not Hopkins, then UofMichigan, Brigghm, etc.... I would also be demanding letter of apology and culpability be signed, notarized, multiple originals produced and sent accross the country to include NIH, PDs, AND ACS, etc..... I would not demand termination of the parties involved. I think if all other demands are met, well.... the Admin/GME would have to make their own conclusion.

Second, as for suit against NIH, I would not as that is suing the government. NIH component in this actually makes for an ally. You see, NIH has certain government & ethical standards for institutions to be eligible, etc.... I suspect Hopkins has a significant number of federal funding sources to include NIH. If what is claimed in legal filing is true, Hopkins places itself at risk of not just loosing 24 large, but having federal funding accross the board pulled for aggregious breach of ethics, "institutional misconduct", and possibility of having residencies closed (as also funded federally). If he has good attornies, they are likely investigating this. Keep in mind the "Judge Sotomayor" matter. She represented an extremely important entity for the Latin/minority community. I suspect Serano has similar if not greater importance. It would not be hard to raise concerns of underlying prejudice & discrimination. I have heard it said that certain folks "have no problem with minorities and love minorities..... love them to stay in their place!". He is not seeking an appointment; rather is defending unjust stripping of an appointment! Serano can get the Latin community to carry this suit far and wide to include ACLU, etc.... This thing can have huge teeth and broad wings. The uglier it gets the more he will have to just push forward cause the defense will require increasing amounts of besmerching & character assassination that at some point becomes unrecoverable and only demands massive cash!!!

Whistle blower suit... "Qui Tam". I have not heard of it at the resident level. However, based on what I have seen, such a suit could be brought. Residencies and hospitals receive, as noted above, large sums of federal funding. This ranges from research grants to resident subsidies. These residencies make certain agreements and/or guaratees in exchange for said funds. If you find patient care being dictated/documented wrongly, i.e. you place a central line & attending NOT present dictates/bills, it is fraud. If residencies are in violation of residency requirements, they are receiving funds ~fraudulently.... i.e. paid to teach and not teaching just pocketing funds. It can be very complicated. However, Serano may be in just such a position at this point that an entire office building of attornies may be deployed to uncover every seedy secret we as residents have been forced to watch and/or participate in as part of "paying our dues".

I think the important thing for him is his legal team. If he wants his reputation and/or career, he needs an attorny team with a political agenda/priority. An attorney team more focused on financial agenda will encourage him to settle, "just move on", etc..... Thus attornies from social justice organizations like the Latin community and ACLU will likely be his best bet.....

Anyways, these are just opinions. I can NOT speak to the merits of this case....

JAD

 

[lipomas]

Having said that, reading that complaint (at least the first part, laying out the facts of his education), could JHU picked a worse case person to fire? The guy is made of gold with silver in his veins. If my information was changed out with his, it would be a slam-dunk. Mine would still look like I was the tool I am, even with whitewashing.

Bad move on one of the administrator's part (I don't recall if it was the PD) was sending out an email stating no negatives to the ACGME. If that is accurate, and is produced at trial, that doesn't look good.

Yeah, that was my thought too - obviously there are some things left unsaid in this complaint that get at whatever deficiencies he has (because we all have some deficiencies). But they are claiming he has a "personality disorder" which is NOT something that just suddenly develops, it is an axis II disorder. And if it was substance abuse they would likely have stated that as a problem. The whole thing just doesn't make sense. I suspect he had problems with many attendings in regards to not toeing the line or maybe going over someone's head a few times, or something like that which made him not great to work with. But none of that would justify what happened afterwards.

 

[ShyRem]

Remember, we're only reading one side of the argument here. It certainly doesn't behoove the plaintiff to accede ANY points to the defense - the plaintiff's job is to paint the best picture possible, make it look as airtight as possible. The defense will then poke holes in every argument and make the plaintiff look terrible.

Makes me wonder what the response to the complaint will look like. I'm sure if you read only the response (once it comes out) you'll think this guy was the worst resident that ever walked the face of the earth and how in the world did he ever get into Hopkins. It's all in how the lawyers paint the picture.

For heavens sakes, these are lawyers. It's worse than getting the story from two four year olds about a fight they were both involved in. The stories will, I'm sure, be wildly different from both the four year olds and the lawyers in the case at hand.

 

[JackADeli]

Remember, we're only reading one side of the argument here...

Makes me wonder what the response to the complaint will look like. I'm sure if you read only the response (once it comes out) you'll think this guy was the worst resident that ever walked the face of the earth and how in the world did he ever get into Hopkins...

Maybe... but, it will, no matter what, call the integrity of Hopkins/PD and others into question if they declare him soooo bad. Especially if they did actually sign some documentation attesting to his ability thus enabling him to moonlight, etc.... Further, if he was in fact the individual asked to serve as "host" or "embassador" to visiting dignitaries, it is hard to say he was socially inept....They may have laid a paperwork trail that just does NOT jive with whatever "horrible" things they declare to defend against the suit.... To get out of this one, you may need to have some Hopkins hot-shot attendings declare that he was clinically/technically inept but "we lied when providing him references and/or attesting to his abilities when seeking clinical privileges...."

JAD

 

[Themistocles]

Makes me wonder what the response to the complaint will look like. I'm sure if you read only the response (once it comes out) you'll think this guy was the worst resident that ever walked the face of the earth and how in the world did he ever get into Hopkins.

Wouldn't really matter. Based on the timing of the whistleblower-induced ACGME visit and the termination (combined with his being in the lab doing research) it's still retaliation.

 

[mercaptovizadeh]

When I had first read this thread, I had no idea the case was this egregious. The attached pdf is hair-raising.

I mean, they called up Steve Rosenberg at the NIH, completely unaffiliated with JHU, much less the surgery department, and they maligned Serrano before him? That's just beyond the pale.

I really don't see how Hopkins can get out of this. It's time for a showdown and for the power-hungry run-amock attendings to get a taste of their own sadistic abusive medicine. I look forward to many more lawsuits. Graduate medical education needs to get its clock cleaned - from the punitive and retaliatory psychiatry, to the inhumane abuse, and the outright fabrications.

One last comment: it's discouraging how many people will turn their back on someone who is being maligned without the production of evidence. Not one person who had previously taken him on for research was willing to step out of line and give him at least a trial period, despite the fact that they had already made verbal or even written commitments.

I have doubts that Serrano will ever be able to complete a surgical residency, but I hope that he will some day be able to complete a residency (hopefully in an unrelated field, considering the disgusting behavior of Hopkins surgery), or get a research position. I feel like research may be the ticket for him, and its sad that he may never have a future as a clinician, but at least he has other interests that he can explore.

Given the hell he's gone through, I wouldn't blame him if he took the $24m and never worked another day.

 

[JackADeli]

When I had first read this thread, I had no idea the case was this egregious. The attached pdf is hair-raising.

...I really don't see how Hopkins can get out of this.
...from the punitive and retaliatory psychiatry, to the inhumane abuse, and the outright fabrications.

One last comment: it's discouraging how many people will turn their back on someone who is being maligned without the production of evidence...

I have doubts that Serrano will ever be able to complete a surgical residency, but I hope that he will some day be able to complete a residency ...or get a research position...

Given the hell he's gone through, I wouldn't blame him if he took the $24m and never worked another day.

This is my take on this matter. In my opinion, if a significant amount of what is claimed is true, the extent and depth of the breach in ethical conduct is astounding. Consider the purportedly letter From Cameron during the match season.... I think that would represent a breach of the ERAS rules and agreement. And, that's even before Serano is in the door at JHU. Now extend it over the three years he was there..... We are talking ACGME violations AND cover-up. That cloud floats over the entire institution even beyond the division of surgery. It extends to the GME division. It extends to medicare/medicaid funding. It extends to ABS/ACS. Now consider the purported signing off on his moonlighting. Either they lied when they signed that and knowingly enabled an unqualified physician to practice outside of JHU or they lied about his qualifications in order to fire him. If they knowingly lied about his competence (or lack there of) enabling him to monnlight.... that extends to all their recent grads that they have "certified" as competent to graduate. It extends to the state licensing boards. It extends to patient safety/endangerment. It extends to ABS when they support grads in sitting for the exam... I could go on and on... the scope is really huge!!!

I honestly believe there is NO reason he can not complete GSurgery residency. In fact, the latin community has already reportedly secured possible alternative SURGERY residency programs to allow him to complete residency.... but, apparently/reportedly his attornies are not allowing for these conversations. He wants to be a surgeon, wanted to be a surgeon, has worked so very hard to become a surgeon. All the corrupt folks win if he abandons his final 2-3 years of training over a lump of cash. He would likely find himself sitting as an IM/ER/FP doctor somewhere in the future with his little stash of cash lamenting how good he was and how he would have been a surgeon if not for "the man" bring him down. Bottom line, if his claim is true, he has no reason to NOT become a surgeon AND get his compensation. Completing surgical residency and getting board certified would be the final component of complete vindication.

$24 large is really NOTHING after attronies and taxes, etc.... He needs to engage a massive pack of politically oriented attornies that are not focused on their piece of 24 million. He needs a group of attornies that will take this to the mat and not encourage him to settle for some sum and move on to a career that was NOT his aspiration/dream. He does not need to become a permanent, minority victim, pushed out by the establishment. If the facts are what he claims in his filing, he CAN achieve some compensation and CAN still achieve his goals and dreams to become a great surgeon. It would be a huge loss to the surgical community and society at large if such a stellar/rockstar candidate was utterly destroyed and pushed out of the ranks. I would also add, if residents at JHU are aware of facts and stay quiet.... they only endanger themselves, future residents.... and patients. Cause, if JHU had no problem jacking Serano, believe me they will have no problem doing it to others... especially if the residents stand in line and become complicit. If JHU wins this with the help of resident silence or resident lying, it will send a message accross the entire country that you can not demand justice and appropriate conduct from your residency.... no matter what specialty.

On 24 million, you should consider.... 1) if winning that sum in judgement, he is likely to NOT receive even half of that after fees & taxes and 2) in practice as a GSurgeon, he could conceivably make in excess of $250-300K per year. Stretch that out over a 30+ year career!!!

I think it would be exceedingly sad if the facts as he presented are accurate and he CHOOSES to abandon surgery altogether. And, make no mistake about it, if he does abandon surgery, it will be of his choosing no matter what the circumstances.... he will have made the choice. I do not want to see another poster child victim minority..... I want to see a winner.

JAD

 

[josenewin]

I know a Med Peds Guy who was fired and then extracted 200grant but he joined another peds residency. Always residents win

 

[JackADeli]

I know a Med Peds Guy who was fired and then extracted 200grant but he joined another peds residency. Always residents win

$200k does not equate.... win.

 

[Lawless]

Wow! I do not know what those women were thinking. Maybe they thought that because they were women, they could not let other women down by losing the program's accreditation on their watch.

They have done just the opposite. Their conduct, if proven, is so outrageous that it shocks the conscience. I have no doubt that if this case goes to trial, they and the hospital will face punitive damages.

Their lawyers are going to have a tough time finding juries without any minorities in Baltimore. More than likely, those lawyers will try to get this case moved to a predominantly white district.

This case brings up many issues. I'll only list a few. How is it that those entrusted with educating residents can betray that trust so wantonly?

How powerful do these people think they are in the eyes of the law that they can trample over civil rights with impunity?

What would have happened had Dr. Serrano, after losing every thing, decided to kill himself?

How is it that programs have avoided investigation when residents end up killing themselves or possibly killing others? Is it just ok to blame it on fatigue and burnout rather than further examining the conduct of a system that is entrusted to train the next generation of physicians?

What did the in-house counsel do to prevent the misconduct? Could a fair pre-termination hearing prevented this whole mess? Did the hospital trust its in-house counsel enough to give him the security to go after such misconduct?

Dr. Serrano is fortunate in that the PD decided to act immediately while he was in a research year. Had this been a clinical year, I have no doubt he would have gotten poor or marginal evaluations in his general surgery rotations while getting satisfactory or outstanding evaluations in his electives. Then the case would be more difficult to prove.

Thus the injustice. This case is a slam-dunk win for Dr. Serrano. The problem is that this fact pattern keeps on repeating itself year after year. Instead it happens to residents of reasonable skill rather than superstar AOA Stanford grads.

The courts have consistently deferred to residency programs when it comes to issues of competency. Yet programs use competency to eliminate those who are clinically competent but are lacking in subjective "core competencies." Look at the complaint to see how the program cited "lack of insight" and "poor interpersonal skills" to justify the dismissal. Although the ACGME thought it was doing the right thing by standardizing evaluations, its dependence on ambiguous "core competencies" allow these abuses to continue.

So this fact pattern will keep on repeating itself until more and more residents bring suits alleging abuse. Only after many repeated exposures will judges finally start interpreting the law to allow further discovery into these allegations. Then they could compel change in the conduct of the system.

It used to be that if a motorist was injured in an accident by two different people, that motorist could not collect anything. The reason being he could not prove which person did the injuring. After many cases, judges changed the common law to allow recovery.

This case can have far-reaching consequences. If successful, it will be referenced by every lawyer trying to bring a similar case. Dr. Serrano can be the Rosa Parks of residents. He can spark change in graduate medical education if he is willing to risk everything and put his faith in a legal system that for the most part condones the current conduct of medical education.

I hope he wins.

Also if Serrano proves his allegations in court, he needs to press these charges to the Maryland Medical Board. This conduct brings dishonor to the entire profession.

Do you guys notice the similarities between graduate medical education and the Catholic Church? If so, this case could lead to a feeding frenzy.

 

[mercaptovizadeh]

See, I dislike the fact that this case takes any tones of minority persecuted by white majority. It will in the courtroom, and Serrano should not take the easy way out of appealing to that issue. I'm glad the legal brief appended only refers tangentially to his ethnicity and doesn't point to it as a source of discrimination.

I believe that ethnicity is irrelevant here. This is a case of a man of integrity being destroyed by several arrogant, unprofessional, and downright criminal individuals.

 

[JackADeli]

...Do you guys notice the similarities between graduate medical education and the Catholic Church? If so, this case could lead to a feeding frenzy.

What are you talking about....(rhetorical, please don't answer).

 

[Socrates25]

The PDF file is shocking. The only way I see Hopkins coming out of this deal is they can show his earlier evaluations and ABSITE test scores and prove that they were consistently way below average.

As the PDF file states, even if they could show that he had persistently low ABSITE scores, its clear that Serrano wasnt the only resident in that position, yet he was the only one fired, in part, due to the supposedly low test scores.

My suspicion is that Hopkins will reply with a brief that shows that they met with him multiple occassions before his termination to discuss his "poor performance" based on evals and test scores. However, even if true, that rings hollow and wont be sufficient to prevail, given that there is ample evidence that they lauded Serrano when it served their purposes for wooing outside faculty and guest lecturers.

If Frieschlag and Lipsett really did engage in the kind of behavior alleged in the PDF file, they should be fired immediately. I dont have any bias against Freischlag, as my limited encounters with her were very pleasant and I never saw any kind of behavior in her thats alleged in the PDF files. She is the first woman chairperson at Hopkins, but the behavior alleged is shocking and she should have someone show her the door if its verified.

Lipsett, on the other hand, I have a low opinion of, simply because she is one of hte sellouts of the medical profession. She set up the CRNA, PA, and NP programs and integrated them with the ICUs and ORs. Part of the reason the Hopkins surgical residents complained that they werent getting enough surgical time is because Lipsett opened the floodgates for the surgical PAs and "first assist" RNFAs to replace residents in the OR.

 

[Taurus]

Heads need to roll at JHU.

More importantly, I hope this case sends a loud and clear message to all residency programs.

Don't settle. We want to hear all the dirt at trial.

 

[exPCM]

The PDF file is shocking. The only way I see Hopkins coming out of this deal is they can show his earlier evaluations and ABSITE test scores and prove that they were consistently way below average.

As the PDF file states, even if they could show that he had persistently low ABSITE scores, its clear that Serrano wasnt the only resident in that position, yet he was the only one fired, in part, due to the supposedly low test scores.

My suspicion is that Hopkins will reply with a brief that shows that they met with him multiple occassions before his termination to discuss his "poor performance" based on evals and test scores. However, even if true, that rings hollow and wont be sufficient to prevail, given that there is ample evidence that they lauded Serrano when it served their purposes for wooing outside faculty and guest lecturers.

If Frieschlag and Lipsett really did engage in the kind of behavior alleged in the PDF file, they should be fired immediately. I dont have any bias against Freischlag, as my limited encounters with her were very pleasant and I never saw any kind of behavior in her thats alleged in the PDF files. She is the first woman chairperson at Hopkins, but the behavior alleged is shocking and she should have someone show her the door if its verified.

Lipsett, on the other hand, I have a low opinion of, simply because she is one of hte sellouts of the medical profession. She set up the CRNA, PA, and NP programs and integrated them with the ICUs and ORs. Part of the reason the Hopkins surgical residents complained that they werent getting enough surgical time is because Lipsett opened the floodgates for the surgical PAs and "first assist" RNFAs to replace residents in the OR.

Great post. Thanks for the firsthand information.

 

[PostLessOne]

Assuming the basic facts in the complaint are correct, what could Hopkins possibly defend themselves with?

Let's suppose for the sake of argument that this resident was 'untrainable' and did poorly during the clinical years. Then why did they give him solid gold evaluations then, and wait to fire him until after he was no longer in the clinic? Basically either they retaliated against him or they were liars.

They used confidential health information against him (and it wasn't even true). Again, a judge is probably going to say that such information is not even a permissible cause, even if the mental health experts had said he was ill.

I know this brief is one sided, it's just hard to imagine what even the $500 an hour sharks that Hopkins probably employs could possibly come up with to get them out of this one. Did they even THINK about discussing the matter with counsel before firing him? Did they really think a resident with a walk on water reputation would just roll over and NOT sue?

 

[mercaptovizadeh]

Assuming the basic facts in the complaint are correct, what could Hopkins possibly defend themselves with?

Let's suppose for the sake of argument that this resident was 'untrainable' and did poorly during the clinical years. Then why did they give him solid gold evaluations then, and wait to fire him until after he was no longer in the clinic? Basically either they retaliated against him or they were liars.

They used confidential health information against him (and it wasn't even true). Again, a judge is probably going to say that such information is not even a permissible cause, even if the mental health experts had said he was ill.

I know this brief is one sided, it's just hard to imagine what even the $500 an hour sharks that Hopkins probably employs could possibly come up with to get them out of this one. Did they even THINK about discussing the matter with counsel before firing him? Did they really think a resident with a walk on water reputation would just roll over and NOT sue?

The funniest thing is that the program didn't even appear to be in trouble with the ACGME after the site review. This case, on the other hand, is threatening the very existence of their residency training program.

I hope protections are enforced for Serrano's erstwhile resident colleagues. If he calls them to witness, or if he calls other faculty who can vouch for him, they have to know that they are protected from retaliation.

 

[lipomas]

See, I dislike the fact that this case takes any tones of minority persecuted by white majority. It will in the courtroom, and Serrano should not take the easy way out of appealing to that issue. I'm glad the legal brief appended only refers tangentially to his ethnicity and doesn't point to it as a source of discrimination.

I believe that ethnicity is irrelevant here. This is a case of a man of integrity being destroyed by several arrogant, unprofessional, and downright criminal individuals.

I agree totally with this - playing the race card or somehow overemphasizing his racial identity is a stupid strategy, and one that would turn me way off as a juror. The fact that he is hispanic doesn't make him any more (or less) of a victim, if what the brief says is true. And the fact that he is hispanic is highly unlikely to have been an issue in a hospital like JHU, unless HE made it one.

 

[Lawless]

Who is to say that race is not invovled? Not all discrimination is active where the defendant intends to discriminate against another.

Other forms are more subtle. For example if two residents make a similar mistake, the attendings might say that the white one is just learning whereas the minority is just unteachable. Maybe the minority has subtle language and culturally based demeanor differences that on a subconsious level irritate the attending, clouding his judgment. Or in this case, had Dr. Serrano been white and from an established family of physicians, the program might have not taken any action or may have just removed him from the program. But that he was an "ungrateful Mexican" from a poor immigrant family, the program thought they could get away with or that Dr. Serrano deserved, a more vindictive response.

His lawyers should plead race because it will allow them another avenue to get past a summary judgment. It is a well recognized cause of action.

In the same spirit, some residents can overcome attempts at their removal by claiming a disability or psychiatric disorder. A program that discriminates on these disabilities will allow the resident a cause of action. The program treads more carefully and involves its in-house counsel. The risk of suit and resulting damages become higher. The program is then forced to re-evaluate whether the cause of action was just or rather a convenient means of settling a petty dispute.

By pleading discrimination due to a disability there is a strongly recognized cause of action that would make summary judgment more difficult and allow the case to go to discovery. Discovery is where the dirty laundry gets aired under a threat of perjury.

If the cause of action is just the program does not have to worry. But with discovery, more facts can be obtained. If those facts support a wrongful termination rather than a legitimate one, then the stakes shoot up remarkably. Heads could roll afterwards.

 

[mercaptovizadeh]

Who is to say that race is not invovled? Not all discrimination is active where the defendant intends to discriminate against another.

Other forms are more subtle. For example if two residents make a similar mistake, the attendings might say that the white one is just learning whereas the minority is just unteachable. Maybe the minority has subtle language and culturally based demeanor differences that on a subconsious level irritate the attending, clouding his judgment. Or in this case, had Dr. Serrano been white and from an established family of physicians, the program might have not taken any action or may have just removed him from the program. But that he was an "ungrateful Mexican" from a poor immigrant family, the program thought they could get away with or that Dr. Serrano deserved, a more vindictive response.

His lawyers should plead race because it will allow them another avenue to get past a summary judgment. It is a well recognized cause of action.

In the same spirit, some residents can overcome attempts at their removal by claiming a disability or psychiatric disorder. A program that discriminates on these disabilities will allow the resident a cause of action. The program treads more carefully and involves its in-house counsel. The risk of suit and resulting damages become higher. The program is then forced to re-evaluate whether the cause of action was just or rather a convenient means of settling a petty dispute.

By pleading discrimination due to a disability there is a strongly recognized cause of action that would make summary judgment more difficult and allow the case to go to discovery. Discovery is where the dirty laundry gets aired under a threat of perjury.

If the cause of action is just the program does not have to worry. But with discovery, more facts can be obtained. If those facts support a wrongful termination rather than a legitimate one, then the stakes shoot up remarkably. Heads could roll afterwards.

Sorry, but claiming disability or race-based discrimination is just total crap and undermines the plaintiff. The point is, Serrano is not a "borderline" guy who's getting screwed because he lacks "white privilege," nor does he suffer a disability. By all accounts, he is/was an accomplished resident and developing scientist. He was terminated because he was politically noncompliant. The very fact that Lipsett and Freischlag so prominently pushed him forward in the first two years of residency eliminates the race and the disability arguments > and that's key.

Serrano's problems are generalizable to ALL residents, not just racial minorities or people with disabilities (what disability did he have? none that I can see). This case needs to set a precedent, that residents cannot be terminated without very good reason, and certainly not for refusing to be coached and lie on ACGME surveys.