Physi­cian ac­cused in nurses’ com­plaint fac­ing state in­quiry

Austin American-Statesman - - METRO & STATE - By Betsy Blaney

LUB­BOCK — Nurses na­tion­wide were out­raged when two of their own were fired and threat­ened with prison time for com­plain­ing anony­mously about a West Texas doc­tor they be­lieved was un­eth­i­cal and risk­ing pa­tients’ health.

The doc­tor had gone to lo­cal law en­force­ment af­ter the com­plaint de­mand­ing an in­ves­ti­ga­tion that iden­ti­fied the nurses, one of whom was forced to go to trial be­fore be­ing ex­on­er­ated, but now, it’s the doc­tor who faces ac­cu­sa­tions — and pos­si­bly the loss of his med­i­cal li­cense. The trou­ble started in April 2009, when the nurse s , Anne Mitchell and Vick­i­lyn Galle, sent an un­signed let­ter to the Texas Med­i­cal Board out­lin­ing con­cerns about Rolando Arafiles Jr., in­clud­ing his al­leged use of herbal reme­dies and at­tempt to use hos­pi­tal sup­plies to per­form at-home pro­ce­dures.

Arafiles, li­censed in Texas since 1998, has said the nurses’ let­ter was in­tended to harm him per­son­ally. They were charged crim­i­nally with felony mis­use of of­fi­cial in­for­ma­tion and fired from their jobs at Win­kler County Me­mo­rial Hos­pi­tal. Charges against Galle were later dropped, and Mitchell was ex­on­er­ated in a Fe­bru­ary trial.

Now, the med­i­cal board has filed a com­plaint al­leg­ing that Arafiles used “poor med­i­cal judg­ment” and “poor de­ci­sion-mak­ing,” over­billed pa­tients, pre­scribed non­ther­a­peu­tic treat­ments and in­tim­i­dated wit­nesses. He could face a wide range of dis­ci­plinary ac­tion, in­clud­ing los­ing his li­cense, board spokes­woman Leigh Hop­per said.

The com­plaint, filed late last month, is the first time al­le­ga­tions con­cern­ing Arafiles’ med­i­cal prac­tices have been laid out in a pub­lic doc­u­ment, but the nurses’ at­tor­ney, Brian Car­ney, said most of the in­for­ma­tion pro­vided by the nurses is in the li­cens­ing board’s com­plaint.

In an e-mail re­sponse, the at­tor­ney rep­re­sent­ing Arafiles in the board com­plaint de­nied that her client “en­gaged in any ques­tion­able” med­i­cal treat­ment.

She also said the U.S. and Texas con­sti­tu­tions gave him the right to go to au­thor­i­ties.

“The de­ci­sion to act upon those in­quiries is a mat­ter of dis­cre­tion among law en­force­ment per­son­nel for which he bears no le­gal re­spon­si­bil­ity and for which, we sub­mit, he can­not and should not be sanc­tioned by the Texas Med­i­cal Board,” Jen­nifer House’s e-mail said.

Among the al­le­ga­tions in the com­plaint, Arafiles is ac­cused of pre­scrib­ing hor­mone re­place­ment ther­apy to a pa­tient with a his­tory of deep-vein throm­bo­sis, which can cause “se­ri­ous com­pli­ca­tions/death,” and of not doc­u­ment­ing the his­tory. The pa­tient de­vel­oped a throm­bo­sis af­ter start­ing the med­i­ca­tion, the com­plaint says.

The un­pro­fes­sional con­duct al­le­ga­tion stems from Arafiles’ de­ci­sion to go to the Win­kler County sher­iff, “a per­sonal friend and pa­tient,” to have the anony­mous let­ter in­ves­ti­gated and to pur­sue crim­i­nal charges against the nurses, the com­plaint states.

The nurses were iden­ti­fied and charged af­ter he filed a ha­rass­ment com­plaint against them and the sher­iff in­ves­ti­gated, the board says.

Nurs­ing as­so­ci­a­tions and health care watchdogs in Texas and across the coun­try ral­lied around Mitchell dur­ing the trial, say­ing the case was a key test of physi­cian ac­count­abil­ity.

State in­ves­ti­ga­tors con­cluded that the hos­pi­tal dis­crim­i­nated against them by fir­ing them for “re­port­ing in good faith.”

The women have filed a fed­eral law­suit seek­ing dam­ages against Arafiles, the hos­pi­tal and its ad­min­is­tra­tor, and sev­eral county of­fi­cials are named as de­fen­dants.

The med­i­cal board’s com­plaint was filed June 22, and no res­o­lu­tion came from an in­for­mal set­tle­ment con­fer­ence with Arafiles. The board then sent the for­mal com­plaint to the State Of­fice of Ad­min­is­tra­tive Hear­ings, re­quest­ing a pro­ceed­ing that could re­sult in dis­ci­plinary ac­tion against Arafiles.

No hear­ing date has been set.

Rolando Arafiles Jr.

Vick­i­lyn Galle

Anne Mitchell

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