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James McGrath is the Managing Partner of McGrath & Grace, Ltd., a law firm that specializes in conducting independent corporate internal investigations worldwide.  The former chief legal officer of a federally-funded narcotics task force in Cleveland, Ohio and a former prosecutor, he has been published in leading legal and compliance and ethics publications, and his writings have been commented on by the Wall Street Journal Online, leading blogs, and the Department of Justice.

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How Not to Run a Texas Hospital Investigation

In 2009, Vickilyn Galle and Anne Mitchell were nurses at Winkler County Memorial Hospital in West Texas.  According to an Associated Press story, they made an anonymous complaint to the Texas Medical Board alleging that a physician there had misappropriated supplies and committed other treatment irregularities.  In what can only be termed an investigations travesty, being whistleblowers got them fired, arrested, and prosecuted.  Proving that everything is bigger in Texas, you are brought this tale of sloppiness and woe.

 The Austin Statesman-American reported that after Galle and Mitchell filed their anonymous complaint about Dr. Rolando Arafiles, Jr. with state regulators, the physician got wind of the complaint.  He, in turn, contacted his personal friend, Winkler County Sheriff Robert Roberts for help with this problem. Roberts started his own parallel investigation that culminated in him seizing the nurses' computers, finding their letter to the Board, and figuring out their identities.

Once identified, the women were arrested and charged with felonious misuse of information, at which point another friend of the good doctor, County Attorney Scott Tidwell, entered the fray.  Tidwell commenced the prosecution of the then not-so-anonymous whistleblowers that surely did not end up as he, Roberts, and Arafiles had anticipated: the charges against Galle were dropped and Mitchell was found not guilty at her trial.

Like an old Quinn Martin television production, this story has a can’t-miss epilogue.

Vickilyn Galle and Anne Mitchell subsequently sued Winkler County, its hospital, Sheriff Roberts, County Attorney Tidwell, and other officials, alleging that their First Amendment rights had been violated and that the prosecutions had been vindictive.  In August 2010, they agreed to $750,000 settlement.  They have presumably returned to nursing, although no doubt a lot less confident in the proverbial “system”.

Robert Roberts was convicted of retaliation and other charges.  As a result, he lost his job, permanently surrendered his peace officer's license, and was sentenced to serve 100 days in jail. 

Scott Tidwell was similarly convicted of retaliation.  He was sentenced to 120 days in jail, fined $6,000, and placed on probation for 10 years.

Dr. Rolando Arafiles, Jr. was reprimanded and put him on probation by the Texas Medical Board for his role in retaliating against the nurses, for improperly treating several patients with thyroid problems and other conditions, and for mishandling patients in the hospital's emergency department.  He must take classes, be monitored by another doctor, and pay a $5,000 fine, per the board's order.

And last, but not least, the Texas legislature enacted a statute that took effect this month barring the state’s Medical Board from considering complaints against doctors if they come from anonymous sources like the one from Vickilyn Galle and Anne Mitchell.

Because that was the problem. 


Comments
S. Caroline Schroder
- 08 October 2011 at 00:44

"[T]he Texas legislature enacted a statute that took effect this month barring the state’s Medical Board from considering complaints against doctors if they come from anonymous sources like the one from Vickilyn Galle and Anne Mitchell." Well, that will really improve healthcare, won't it....like tort reform...
Joseph Agins
- 08 October 2011 at 00:48

One word. Wow!

Truth is so much more entertaining than fiction. You could not have made up a better story of what not to do.

Roger Kohn
- 10 October 2011 at 23:13

Great article.
Robin Giangrande
- 10 October 2011 at 23:15

Great story - although not surprising, for Texas or anywhere else, I am afraid. If you haven't seen it already, see the documentary film "Do No Harm", the story of two reluctant whistleblowers in a small Georgia town who endure relentless attacks as they struggle to draw national attention to hospital corruption and the plight of the uninsured - http://www.donoharmdoc.com.
Mahmoud Sher-Jan
- 10 October 2011 at 23:22

A very well written piece which describes how justice (or injustice for that matter) are handed out in TX. Texas has a reputation to protect and "real" stories like this only serve to extend the mystique.
Andrew J. Yu
- 10 October 2011 at 23:32

Respondents who possess power or connections will very likely attempt to influence or thwart any investigation into the complaint(s) using that power or those connections, even if it ventures into unethical or illegal territory. To expect powerful and well-connected respondents to roll over and play dead while the complaint(s) are being dealt with is utterly unrealistic. That is why it is of crucial importance that investigators are completely independent in every possible way.
S. Caroline Schroder
- 10 October 2011 at 23:36

CBS News indicates that Tidwell was 'filling in" for an unavailable District Attorney. See: http://www.cbsnews.com/stories/2011/10/04/ap/business/main20115695.shtml
According to the State Bar site, Tidwell seems to be an actively licensed Texas lawyer listing no public disciplinary record and not only eligible to practice in Texas but currently in private practice.

Thank you for highlighting this story.
Steve Gibson
- 13 October 2011 at 00:44

Good for them for not allowing anonymous complaints. I have a co-worker who I competed with for a promotion. I won and he has made several anonymous whistleblower complaints and even been heard bragging to co-workers that he did it. Each time I get called in to answer questions and they have NEVER found anything wrong! I applaud Texas.
Craig Brueckman, CFE
- 13 October 2011 at 06:05

No good deed goes unpunished. The nurses are to be commended for reporting the doctor. Perhaps something from the NHCAA? Case highlights the dangers and trials (literally) whistleblowers may face. But doing the right thing has always had its costs.
Tamara Calvert
- 13 October 2011 at 06:11

That is good to know and have other states adopted the anonymous complaint theory yet? Would love to know. Has our president tried to enact anything like this into Obama care or is this outside of Obama care?
Jeannie Autry
- 14 October 2011 at 02:55

A "never event" in healthcare is an inexcusable occurrence with grave significance; the retaliation that occurred in Winkler County against two nurses who made a good faith report about patient safety concerns to the Texas Medical Board is a never event. Nurses play a critically important role in identifying and voicing concerns about patient safety so they can be addressed. No one benefits when nurses are silenced.

Senate Bill 192 strengthened nurse advocacy protections by providing immunity from criminal liability and increasing fines that licensing bodies can impose for retaliation. The Texas Nurse Association is working to develop a Nurse Advocacy Certificate Program which was presented at the National Nursing Ethics Conference as well as the ANCC Pathway To Excellence. The Director of Practice for TNA will be presenting the keynote speech at the American Association of Legal Nurse Consultant Regional meeting in San Antonio Texas March 30-31, 2012 [see www.aalnc.org]. Ms. Zolnierek will tell us how events in Winkler County have impacted nurses in Texas and nationally.

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