Was it negligence—or politics?
Doctor accuses Enloe of filing false complaints as payback for his criticisms
A former Chico physician under threat of losing his medical license is fighting back, contending that the charges against him are politically motivated because of his willingness to blow the whistle on poor practices at Enloe Medical Center.
Early this month, the Medical Board of California filed an accusation against the license of local general and vascular surgeon Dr. Vincent Mazzarella, who was part of Enloe Medical Center’s medical staff from October 2005 until January 2007. The accusation, based on complaints received from Enloe, lists five causes of action—an act of gross negligence, three acts of negligence, and one of dishonesty.
A check of Medical Board records indicates that these are the first complaints to be levied against Mazzarella.
The physician, who currently practices at Colusa Regional Medical Center, could have his medical license either suspended or revoked if the accusation is successful.
He is confident, however, that “it will all come out in the wash” during his Medical Board hearing—which he said may not occur for another six to eight months—and insists that he is innocent of any wrongdoing.
Mazzarella described the complaints that led to the accusation as “inaccurate and misleading,” and said that he was singled out for removal, in particular by two senior physician-administrators, Dr. Joseph Matthews and Dr. Denis Westphal—part of a group of what he called “good old boys”—because he was a whistleblower and was also perceived as unwelcome competition for private-practice patients.
“Three years ago [shortly after Mazzarella started working at Enloe], Enloe was in turmoil,” explained Mazzarella. “The operating rooms were so dysfunctional that an outside consultant was brought in to reorganize [them]. Before they could do that, the entire anesthesiology department quit. Consents for operations were not being obtained correctly, medical-records processes were faulty, and trauma practices and backup-surgeon availability were inadequate.”
He pointed out that “the multiple fines levied against Enloe by federal and state organizations” during the period he worked there are well-documented.
Mazzarella—who came to Enloe from Kaiser Permanente in Honolulu, where he was an emergency-room surgeon—was vocal from the get-go, he said, in calling attention to what he saw as serious flaws in the way Enloe was operating. But the incident that sealed his fate, he said, occurred in December 2005, two months after he got there.
“A kid tried to commit suicide by shooting himself in the head,” Mazzarella related. As the trauma surgeon on call, he had received the telephone call that the boy was in the emergency room. “I lived 20 minutes from the hospital. I told them to call a neurosurgeon right away. They said, ‘No, it’s not Enloe protocol’—word for word. Because [Enloe] neurosurgeons didn’t want to be bothered, didn’t want to be called in on every Friday or Saturday night for every drunk who hit his head, they had this ‘custom’ to evaluate the patient first, and only after that would they call in a neurosurgeon.”
“I got there,” he continued, “called the neurosurgeon and told him, ‘Get here as fast as you can.’ He operated and saved the kid’s life, but it was an extra 20 minutes that could have killed him.
“I raised holy hell,” said Mazzarella. “I don’t know of any place where, when a kid shoots himself in the head, you don’t call the neurosurgeon first. In fact, it’s written in the protocol of most trauma centers.”
Mazzarella said he brought up the incident in a trauma department committee meeting during which Westphal, who was head of the department, and nurse/trauma coordinator Judy Collins both defended Enloe’s policy.
“I told them, ‘You people are out of your minds,’ ” said Mazzarella. “It was shortly after that that Dan Thomas [a local plastic surgeon who was Enloe’s chief of staff at the time] came up to me and said, ‘I think you’d better go. We don’t like you here. We want you to leave. You can leave quietly and nothing will happen to you.’ ”
“If I had been willing to play politics,” said Mazzarella, “I wouldn’t be in the pickle I’m in. … I became a pariah at Enloe.”
What followed, he said, was a series of fabricated charges against him, spearheaded by Westphal, whose surgery practices Mazzarella had called into question, and Matthews, who chaired the surgery department at the time.
These charges, said Mazzarella, did not go through the normal, transparent peer-review process, but were instead the subject of a “pseudo-peer-review” discussion involving Matthews, Westphal, Westphal’s practice partner, and two retired physicians. Including retired physicians in any sort of peer review “is not normally done anywhere,” added Mazzarella.
One of the negligence charges listed in the accusation concerned a 14-year-old girl who was admitted to Enloe writhing with severe abdominal pain.
Mazzarella said he discovered after opening her up that the girl was suffering from a rare condition called superior mesenteric artery syndrome, which caused intestinal blockage and caused her stomach to distend to five times its normal size, almost filling her entire abdomen.
“I called in Westphal and Matthews to help, but neither of them would come in,” said Mazzarella. “They said to close her up and send her to UC Davis. I said, ‘You guys are jerks.’
“Then Matthews started saying around the hospital that I found a tumor in a girl that I couldn’t cut out, and that I was going to cut out her stomach thinking it was a tumor, but he stopped me,” continued Mazzarella. “The complaint still says that there was a tumor that I couldn’t cut out. I actually think that’s going to be an easy one at the Medical Board. And I’m much more likely to get a fair hearing at the Medical Board because they have a judge.”
As for the charge of gross negligence, concerning an April 2006 laparoscopic surgery that resulted in a perforated bowel (which was repaired), Mazzarella stated that “injury to the intestine is an uncommon but well-known complication” in such a case, and “circumstances … did not represent a deviation from the standard of care.”
“You know,” offered Mazzarella, who was hired at Colusa Medical Center after he lost his privileges at Enloe, “Colusa told me, ‘Yeah, we know Enloe. Come on down here.’ They didn’t even blink an eye.”
Laura Hennum, Enloe’s vice president of Strategy, Communications and Marketing, issued a written comment on the case: “Dr. Mazzarella’s claims of improper conduct by Enloe Medical Center and its medical staff are not based on fact. The truth is that we have well-established policies, which we follow closely and uniformly, for conducting fair and appropriate review. …
“When the Medical Board of California files an accusation against a physician’s license to practice in the state, it is not based on blind acceptance of any information that is obtained from a hospital, patient or other source. The Medical Board investigates every issue carefully, by interviewing witnesses, reviewing medical records and other reliable documents, and using its own chosen experts to evaluate a physician’s competence. We are confident that the Medical Board will confirm this.”
Phone messages left for Westphal, Matthews and Thomas were not returned.
“I think [new President/CEO Mike] Wiltermood actually has a shot at reforming Enloe,” Mazzarella said. “I’m seeing changes at Enloe that make me optimistic. If they could just get rid of the few last hold-outs, like Matthews, that are preventing Enloe from completely reforming …”