ST. ALBANS — A former orthopedic surgeon, who resigned amidst an investigation into his conduct while at the local hospital, has revived allegations that someone on the staff at Northwestern Medical Center (NMC) deliberately infected his patients with bacteria during surgical procedures in Dec. 2003.

Dr. Raymond A. Long originally filed suit against NMC in 2005. After three years, NMC’s insurance company reached a $4 million settlement with Long, although NMC maintained state investigators already had cleared it of any wrongdoing. In the new suit, Long is seeking unspecified monetary damages, court costs and the removal of an NMC report to the National Practitioner Data Bank concerning his resignation.

In the past two years, Long has filed three lawsuits, one against his attorney in the original NMC suit, Lloyd George Parry, alleging professional negligence, breach of contract and fiduciary duty, and violation of Vermont’s consumer protection law. Long has also made allegations against Parry in relation to a suit Parry filed against Long over payment of legal fees.

Long and members of his family also have filed suit against Merrill Lynch over an alleged mishandling of a $40 million family trust that has severely diminished the value of the trust.

Long’s revived case against NMC stems from an effort by Long in 2011 to remove an adverse action report NMC made to the National Practitioner Data Bank (NPDB) when Long resigned from NMC on April 7, 2004, the day after he was informed of the outcome of an internal NMC investigation of his conduct.

Hospitals are required to report to the data bank when a practitioner resigns amidst, or in order to prevent, an investigation that could lead to disciplinary action.

NMC made such a report regarding Long in 2004.

According to Long’s legal filings, such a report makes it difficult for a physician to find work, although Long’s attorney told the online news site VTDigger he is currently practicing medicine in Florida. Florida’s licensing database shows that while Long has a valid license in Florida, he does not have admitting or staff privileges at any Florida hospital. Long, however, has written books on yoga and anatomy and conducts yoga classes around the world.

In August 2011, Long asked NMC to withdraw its report to the national data bank administered by the U.S. Dept. of Health. NMC refused.

Long then requested a review by the Secretary of Health, who, in turn, requested NMC provide a timeline of events leading to Long’s resignation and NMC’s report to the data bank.

NMC responded by providing a timeline of events and internal communications concerning the hospital’s investigation of Long in the spring of 2004.

It is the information supplied to the National Practitioner Data Bank that led to the current litigation. “If that hadn’t happened, you wouldn’t be looking at anything right now,” said Long’s attorney Herbert Ogden, who is representing Long in both this case and the case against his former attorney, Parry. When Long accepted the settlement of his 2005 suit against NMC, he agreed to a dismissal with prejudice, meaning he could not bring the same allegations again.

“If you repeat something that’s libelous, the case starts up all over again,” said Ogden.

In the current suit, Ogden wrote on Long’s behalf that NMC’s response to the NPDC made it appear:

  • “That plaintiff was emotionally unstable and unsuitable for his profession because he contended that there was criminal conspiracy against him that in fact did not exist;
  • “That plaintiff’s belief there was such a criminal conspiracy was evidence of psychiatric problems because defendant NMC had undertaken an extensive independent investigation of plaintiff’s allegations that revealed no such conspiracy; and. . .”
  • “That plaintiff resigned from the hospital because he did not want to submit to an independent psychiatric examination.”

NMC’s Jan. 31, 2012 response to the NPDC’s request for information is confined to the original documents themselves, a summary of when meetings were held or documents composed, and a three-sentence letter from NMC CEO Jill Berry Bowen.

Current NMC staff does not appear to offer any conclusions about Long’s fitness, confining them to supplying the requested documentation, which is now part of the court record.

Former NMC CEO Peter Hofstetter, who also was a named defendant in Long’s previous suit, on March 8, 2004 requested that the Medical Executive Committee (MEC) conduct a review of Long’s performance. The request states Hofstetter had been received reports and statements from the Surgical Services Nurse Manager and the Clinical Team Leader for Radiology regarding disruptions caused by Long.

Long believed that someone in the hospital was responsible for bacterial infections that occurred in three of his patients in Dec. 2003. Unhappy with NMC’s response to his concerns, he had begun making changes to infection prevention protocols prior to his surgeries.

Hofstetter asked the MEC to consider whether Long’s actions could have a negative impact on patients by delaying surgeries or increasing the risk of infection. In his 2005 complaint, Long describes trying to convince his colleagues to remove a patient requiring emergency surgery from the operating room so he could continue his own pre-operative preparations.

A week after Hofstetter’s request an ad hoc committee created by the MEC to do a peer review of Long recommended he undergo a psychiatric evaluation. They also suggested Long be advised to conduct himself in a courteous and professional manger when dealing with other staff.

The committee also recommended that Long’s charts be sent for an external peer review, including charts that had already been reviewed internally.

The ad hoc committee also recommended a review of post-operative shoulder infections by Rick Lamb, RN, NMC’s Infection Control Practitioner.

On April 6, the MEC reviewed the ad hoc committee’s recommendations and issued a memorandum decision requiring Long to undergo a psychiatric evaluation within 30 days. The MEC also wanted Long to agree to not operate on any patients until the MEC had received the psychiatrist’s report.

If Long did not agree to the review, his clinical privileges were to be immediately suspended.

The MEC also ordered Surgical Services to undergo an external review to post-operative infections and recommended outside consultants be retained as soon as possible. Further, the review was to include Long’s infected patients, but was not to be limited to them.

Long was sent a letter informing him of the decision on April 6. The letter also outlined Long’s appeal rights and the procedures for an appeal.

Long responded with a one sentence resignation the following day.

After reviewing the situation, the Dept. of Health concluded NMC’s report to the NPDB had been appropriate and would remain in place.

In his new lawsuit, Long contends NMC should not have supplied the requested documents to the Dept. of Health because NMC should have known Long’s patients were deliberately infected.

Long also claims that further investigation will reveal that an independent investigation at the time would have exposed the deliberate infections.

It is unclear how much new evidence will be uncovered in this case, given the three years of evidentiary discovery undertaken in the first case.

Infections

Long does have something this time around which he did not have the first time – a paid expert witness.

Dr. William Jarvis is an acknowledged expert on infectious diseases in hospitals. He worked for the Centers for Disease Control and Prevention (CDC) for 23 years, including serving as the acting director of the Hospital Infections Program. While he did not write the book on hospital infections, titled “Hospital Infections,” he did edit it.

Jarvis, according to court papers, has examined the records of the three infected patients and a fourth who may have been infected. He concluded that “a much more likely explanation” for the infections “is that the patients were intentionally infected through extrinsically and intentionally contaminated irrigation fluid… provided by NMC personnel and used by Dr. Long in the surgical procedures of these patients.”

He based his conclusion on the rarity of post-operative infections following musculoskeletal procedures of the type performed by Long. According to Jarvis, the rate of infection following this kind of surgery is 0.63 per 100 procedures, or less than one percent.

In addition, the types of bacteria with which the patients were infected were also not commonly found in hospital infections, said Jarvis. Although all three infections were caused by different types of bacteria, all three were treatable with common antibiotics. It is much more common for hospital infections to involved antibiotic resistant bacteria, according to Jarvis’s report.

Finally, the bacteria used in laboratory testing involved in the infections had all been ordered by NMC in the weeks prior to the infections, Long maintained.

In his filings, Long has offered multiple explanations for why his patients were allegedly infected. His original lawsuit revolved around antitrust claims and argued the hospital favored another orthopedic surgeon over him. In this suit, he revives another claim, that his interest in adding an MRI machine at his practice would have put him into competition with NMC, which was also planning to purchase an MRI machine.

Prior to filing the original suit Long publicly claimed the contamination was in retaliation for his status as a “whistleblower” regarding anesthetic complication rates, billing and other hospital practices.

NMC has long pointed to investigations by the Vermont Dept. of Health and the Vermont attorney general as having exonerated the hospital.

Ogden provided the Messenger with notes from interviews conducted by a Dept. of Health investigator, but it is not clear if a formal report was ever issued.

The interview notes appear to focus on Long’s conduct with some information about sterilization procedures.

Following his departure from NMC, five of Long’s former patients filed malpractice suits against him. Two cases were filed in federal court. Both involved alleged surgical errors and were settled.

Three cases were filed in state court. Two were settled. The Messenger was unable to determine the outcome of the fifth, which was filed on behalf of one of the infected patients. In two of the state cases, NMC was also a named defendant. The other cases were filed against Long alone.