1998
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NATIONAL REPORTING |
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Flawed and Sometimes Deadly Part 3: Some children disabled for life
State medical boards have trouble overseeing doctors in the military because the boards were never designed to police physicians practicing outside their borders. Investigators in some states have no authority or budget to conduct investigations in other states, and many of the laws and safeguards imposed by states to protect the public don't apply to military doctors. On May 18, 1992, the mother of a child who contracted meningitis filed a $10 million claim against the Navy, alleging Dr. Edner C. Monsanto, the chief pediatrician at the Navy base in Kings Bay, Ga., missed the diagnosis. The child is disabled for life. The Navy paid $2 million. "We could find no quality review board that he went through that you would find in a civilian hospital after an incident," said Joshua A. Whitman, a Jacksonville, Fla., attorney. Georgia requires that such incidents be reported to the medical board through a variety of sources, including insurance companies. "That would be a standard of care issue and an investigation would be launched," said Kara Jones, spokeswoman for the Georgia medical board. "My opinion is that it would be brought to our attention." But Monsanto didn't have a Georgia medical license, and the $2 million wasn't paid by an insurance company that might have increased the cost of his policy. Taxpayers paid it. "Federal licensees are going to be exempt from our jurisdiction," Jones said. "We have to depend on the states that license them to discipline." The state that did license Monsanto - New York - didn't even require him to maintain the registration there. His registration lapsed in February 1997, a violation of military guidelines and a reportable offense under the New York medical board rules - had he worked in New York. "A doctor who doesn't practice in New York doesn't have to maintain an active registration," said Rita St.John, who oversees the disciplinary unit for the New York Division of Professional Licensing. Thirteen months after the Navy settled the meningitis case, it settled a case involving another injured child who had received treatment from Monsanto. Emily Houck was taken to see Monsanto several days after she was born. She had tiny blisters on her head, and Monsanto suspected herpes, which he later acknowledged could have been treated with a toothpaste-sized tube of ointment. But he didn't give her the ointment. Four days later, Emily returned, running a fever and losing weight. "Dr. Monsanto checked her and said she'll be fine," said Emily's mother, Debbie Houck. "Those were his exact words: She'll be fine. These words haunt me now." Emily, now 5, will never be fine. The fever she later developed from the infection damaged her brain. She cannot speak. She cannot walk. She cannot see. She cannot hear. She rarely smiles. She spends her days in a $5,000 wheelchair or rolling on the carpet. "She does not cry. She kind of yells. We've deciphered which yell is for what," her mother said.
Attorney John S. Myers of St.Marys, Ga., sued the Navy and won $4.2 million for Emily and her family, bringing to more than $6 million the amount paid to Monsanto's patients by U.S. taxpayers in a 13-month period. Monsanto's official record remains unblemished. Monsanto couldn't be named as a defendant in a lawsuit because he was a military physician. Monsanto also has no record of disciplinary action with the State Federation of Medical Boards, the clearinghouse used by medical boards across the country. And Navy records show that Kings Bay has never reported a disciplinary action to the National Practitioners Data Bank, which is used by hospitals across the United States to screen doctors. Monsanto still works at Kings Bay. He did not respond to messages left on his home and work phones. States must trust military supervision With doctors practicing so far from the states where they're licensed, state medical boards are forced to depend on the military for information. But the military is sometimes reluctant to criticize its doctors, even to state medical boards. "It (the military) is a good opportunity for physicians with problems to hide out," said Dennis Carr, who retired a few months ago as assistant director and chief of compliance for the Iowa Board of Medical Examiners. "If they're a long way away, there's no way to keep track of them." Dr. Jerry L. Mothershead's Virginia medical board file shows he went to work in 1987 at a Norfolk, Va., emergency room after he had been drinking. That same year, while still in the Navy, he got treatment, then reported to duty drunk again. In 1988, he got more treatment, and in 1989, he started drinking again. Between 1991 and 1994, he reported a dozen episodes of drinking that lasted three-to-four days each. In March 1994, he got treatment. A year later, his urine tested positive for alcohol, prompting yet another treatment. In April 1995, Virginia medical board records say, he drank vodka for "approximately one week" before he was admitted to Portsmouth Naval Hospital. In June 1996, Dr. W.A. McDonald, commander of the United States Navy Medical Corps, wrote to the Virginia medical board: "I have seen no evidence that Dr. Mothershead's alcoholism has any current impact on his ability to practice medicine." Mothershead is still in the Navy, working at Portsmouth Naval Hospital in Virginia. Mothershead didn't return a telephone call, but a Navy spokeswoman said he has been open and honest about his drinking. "He knows he's got an alcohol problem," she said. Department of Defense officials said the military handles doctors who abuse drugs or alcohol differently than civilian health officials do. "Rather than reporting these individuals, we encourage them to seek treatment," says a written statement from military health officials. "The decision to approach this issue in this manner is based on the premise that colleagues will help one another to seek treatment much sooner than they will step forward to report such behavior in a fellow practitioner."
next: Military slow to report bad doctors to states
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