Report cites widespread failures at CMC related to troubled heart surgeon

ByPAUL CUNO-BOOTH

New Hampshire Public Radio

Published: 06-12-2023 1:00 PM

A report commissioned by Catholic Medical Center in Manchester recommends changes to the hospital’s leadership structure and oversight practices, after a Boston Globe investigation last year documented repeated failures to act on concerns about a top heart surgeon with a troubling record of medical errors.

The Globe reported that hospital leaders ignored or dismissed warning signs about Dr. Yvon Baribeau, including concerns that top medical officials and other coworkers raised about the surgeon’s care. Baribeau, who retired in 2019, ultimately racked up 21 malpractice settlements related to his work at the hospital, including 14 linked to patient deaths.

Catholic Medical Center hired an outside law firm, Horty, Springer & Mattern, to conduct an independent review in response to the Globe’s reporting. The hospital released that report to the public Wednesday.

The report says hospital leaders missed opportunities to hold Baribeau accountable and subject him to greater oversight, then reacted defensively when malpractice allegations, a whistleblower lawsuit and other events brought greater scrutiny at the end of the surgeon’s career.

Those events “should have served as an early warning sign and triggered an in-depth analysis of organizational accountability and systemic opportunities for improvement,” the report’s authors, Susan Lapenta and Henry Casale, wrote.

Instead, they wrote, administrators opted for a more defensive stance: “Valuable time and credibility were lost in pursuit of that strategy.”

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The report also identified shortcomings in the hospital’s peer review process, which evaluates doctors’ actions in cases when something goes wrong. In 2020, 17 malpractice claims against Baribeau, involving cases from prior years, were settled; the report notes that there had been no peer review in eight of those cases.

“Despite being highly skilled and technically proficient, Dr. Baribeau had occasional cases that raised serious concerns about his judgment and decision-making,” Lapenta and Casale wrote. “When confronted with concerns about these cases, Dr. Baribeau rarely accepted responsibility and instead seemed to deflect attention away from himself by questioning the process and/or the care provided by others.”

The report criticizes hospital administrators for actions they took against top medical personnel who spoke up about Baribeau, which many on the staff saw as retaliatory. The report’s authors said that fostered distrust and “the perception of a culture of retaliation.”

For instance, when one high-ranking physician, Dr. David Goldberg, was abruptly ousted, many medical staff members viewed it as an attempt to sideline someone voicing concerns about the prominent heart surgeon.

The hospital “has the right to employ, or not employ, physicians as it sees fit,” the report states. “However, Dr. Goldberg’s sudden and unexpected departure resulted in the term ‘Goldberged’ being coined; the term is now used to explain whenever a physician leaves CMC without explanation.”

The report described hospital administrators as more interested in controlling employees than listening to them, with some medical staff members saying they felt their suggestions and concerns were “slapped” or “smacked down.”

The firm’s report was based on interviews with more than 90 people and a review of more than 300,000 pages of documents. Its authors wrote that the Globe’s reporting was generally accurate, though they disputed some of its findings. They also rejected the idea that financial incentives influenced the decision to let Baribeau, a top revenue earner for the hospital, keep operating.

The report’s recommendations include restructuring the senior leadership team, as well as improvements to the peer review process and other internal quality management systems.

“I accept the findings of this independent review and I take responsibility for them, especially those areas where we have fallen short and could have done better,” Catholic Medical Center President and CEO Alex Walker said in a statement that accompanied the report’s release. “I am committed to building on the strengths identified in the report and working to implement the recommendations necessary for us to improve and move forward.”

In a statement, state Rep. Mark Pearson, who chairs the Department of Health and Human Services Oversight Committee, said he appreciated hospital officials’ willingness to act on the report’s findings.

“I will continue to watch and encourage them,” he said.

The full report can be read at cmc-commitment.com

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