Omaha Hospital Sued After Pediatric Surgeons Resign

Marcia Frellick

January 18, 2019

Children's Hospital and Medical Center in Omaha, Nebraska, is a hospital with grand ambitions to gain a higher profile in its community and beyond, with new buildings planned and an aggressive campaign to hire more top specialists. But those plans are now facing some serious headwinds, as 10 surgeons have reportedly resigned in protest over the quality of patient care. The hospital, its CEO, and one of its surgeons are now embroiled in legal challenges, the Nebraska Medical Association is "concerned," and its reputation is at risk.

Two of those 10 surgeons filed suit this month against the hospital, its CEO, Richard Azizkhan, MD, and a neurosurgeon they claim is incompetent.

The hospital says it strongly disagrees with the allegations in the complaint.

According the lawsuit filed by Mark Puccioni, MD, a pediatric neurosurgeon, and Jason Miller, MD, a plastic surgeon and craniofacial specialist, Children's Hospital paid neurosurgeon Adam Conley, MD, $50,000 to join Puccioni's practice in 2017 on a recommendation from Azizkhan.

According to information in the lawsuit, Conley had moved to Omaha after undergoing training in the Cincinnati area. Azizkhan moved to Omaha in 2015 after serving as chief of surgery at Cincinnati Children's Hospital.

The lawsuit says that Puccioni soon became concerned about Conley's skill level and expressed those concerns to Children's Hospital's administration.

The lawsuit alleges that Conley then retaliated by spreading rumors that Puccioni was abusing drugs.

Tom White, lawyer for Puccioni and Miller, told Medscape Medical News, "Puccioni immediately went in, was tested, found negative, and Children's insisted he be tested again, and again it was negative. They wanted him evaluated by a psychiatrist. He did that, and the psychiatrist wrote a scathing letter to Children's saying that 'Dr Puccioni is perfectly fit to practice medicine.'"

A 7-Month-Old Treated by Conley Dies

In the fall of 2018, Conley operated on a 7-month-old at Children's. According to the lawsuit, the two doctors say Conley lost control of bleeding in the brain, and the child died on the operating table. According to the lawsuit, "at one point he [Conley] reportedly poured a significant quantity of hydrogen peroxide directly into the cranial cavity in an effort to stop the bleeding."

Puccioni "was horrified by the death of the child, which he reasonably believed was caused by the incompetence of the surgeon," the lawsuit states.

Puccioni then communicated to the hospital's administration his concerns that Conley was not fit to operate. Miller, who had operated with Puccioni for a decade, was "similarly shocked by the actions of Dr Conley," the lawsuit states, and also communicated that to the administration. According to the allegations, within a few days of writing those letters, Puccioni's and Miller's privileges to practice at Children's were suspended.

The lawsuit states that after the two doctors' suspensions, the hospital misdirected patients and told them either that Puccioni and Miller had retired, moved away, or could no longer treat them.

White said that under threat that the suspensions would be reported to the state of Nebraska and their reputations ruined, both Puccioni and Miller resigned.

Miller told NBC's Omaha affiliate WOWT: "I didn't want to resign, but I felt it was something I had to do."

According to several news reports, eight other surgeons have also recently resigned their privileges at Children's.

Puccioni and Miller charge in the lawsuit tortious interference with a business relationship, deceptive trade practice, wrongful termination, and intentional infliction of emotional distress.

White said, "What you have is an unhealthy drive to own and control a practice. The hospital has an improper vested interest in protecting a physician who isn't really competent."

Hospital Strongly Disagrees With Allegations

In a statement shared with Medscape Medical News, Children's Hospital and Medical Center said it "does not comment on pending litigation other than to say we strongly disagree with these allegations. We stand behind our executive leadership, medical team and our processes, and are confident that these claims against our hospital, Dr Azizkhan and Dr Conley will be proven to be without merit.

"We are also saddened by the manner in which this family's tragic loss has been utilized by the plaintiffs in this litigation. We have spoken with the family to express our shock with the way this extremely personal and painful situation has been publicized."

Nebraska Medical Association President Britt Thedinger, MD, wrote in a December 11 letter to Children's Hospital's board:

"I have received numerous calls and comments from physicians in Omaha, Lincoln and Greater Nebraska about the current state of affairs at Children's Hospital regarding patient care, safety and quality.

"In addition, we as physicians are concerned about the summary suspensions, terminations and resignations of long-time outstanding physician colleagues.... My constituents and I are concerned about current leadership methods."

Parents Concerned

Further allegations involving Azizkhan have been reported by several news organizations in relation to his tenure at Cincinnati Children's Hospital.

WOWT reported that in Cincinnati, Azizkhan was one of the supervisors of surgeon Atiq Durrani, MD, and that last month an Ohio jury ordered Cincinnati Children's Hospital to pay $2 million for what was described as a botched spinal surgery performed by Durrani on an 11-year-old. WOWT reports that Durrani also faces multiple federal charges and made "significant profits for unnecessary surgeries in Ohio."

"Azizkhan will be named as a defendant to all 528 lawsuits based on the work of Dr Durrani in Ohio," WOWT reported.

WOWT reported that some parents of patients at Children's in Omaha were alarmed by the recent events.

"Complete shock that my boys' surgeons are no longer there," the NBC affiliate reported one mother saying. "I mean, what is going on?"

In a tweet on January 4, Puccioni tried to quell fears: "To all the children of Nebraska... YOU ARE SAFE!! We good doctors will keep you safe and secure. Don't worry and sleep well. We've got this."

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