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quid pro quo

ˌkwid ˌprō ˈkwō/

noun

A favor or advantage granted or expected in return for something.

Unless decisive action it taken over the next few days, our theory that nothing gets done about official chicanery, shady dealings and outright corruption will have been validated at the highest levels of state government.

And lest there are those who think I’m beginning to sound like a broken record, let me assure them that I will keep pounding the keyboard as long as I am physically and mentally able to put the glare of the spotlight on them and their deeds.

At one point in 2015, someone said to me, “Once Bobby Jindal leaves office, you won’t have anything to write about.”

Not a chance.

Unfortunately, as long as politicians are intoxicated by money and power, there will be plenty to write about. And, as Johnny Mathis sang his song The Twelfth of Never, “that’s a long, long time.”

Take Kristy Nichols, for example. Someone, please. (Sorry, Henny Youngman.)

Or, just for fun, compare the strikingly similar cases of Ascension Parish President Kenny Matassa and Louisiana Attorney General Jeff Landry.

Kristy, as LouisianaVoice reported last September, jumped the Jindal ship to join Ochsner Health System as Vice President of Government and Corporate Affairs (read: lobbyist).

https://louisianavoice.com/2015/09/17/more-on-kristys-new-job-it-seems-ochsner-gets-17-6-million-for-running-chabert-hospital/

The only problem with that was that as Commissioner of Administration for Jindal, she presided over virtually every facet of state government except the legislative and judicial branches, but worked closely with those as well. State law prohibited her from lobbying the administrative and legislative branches but apparently there was nothing to prevent her from lobbying local governmental entities.

On November 5, 2015, less than two months following our story, Kimberly L. Robinson, an attorney with the Jones Walker law firm, acting on behalf of Ochsner, requested an advisory opinion on the question of whether or not Kristy could legally lobby the state.

A month later, Gov.-elect John Bel Edwards named Robinson as the new Secretary of the Department of Revenue, prompting her resignation from Jones Walker.

http://www.nola.com/politics/index.ssf/2015/12/john_bel_edwards_appoints_kimb.html

Robinson was replaced by R. Gray Sexton as counsel for Kristy.

Sexton was an obvious choice, given his years as Chief Administrator for the Louisiana Board of Ethics. His knowledge of the system was so keen that in 2007, he pulled his own end-run when he resigned and the board immediately rehired him in a new capacity which allowed him to skirt a requirement under a newly-passed ethics law that he disclose clients in his private law practice (how’s that for irony?).

http://blog.nola.com/times-picayune/2007/07/ethics_administrator_quits_the.html

But back to Kristy’s dilemma.

On December 16, Sexton submitted a request to the ethics board to withdraw the request for an advisory opinion. Then, on January 22, 2016, Sexton submitted an Application for Declaratory Opinion on behalf of Kristy. That was followed by a request to withdraw the Application for Declaratory Opinion on March 31. The board granted the request to withdraw at its April 15 meeting.

The chronology was provided to LouisianaVoice in an e-mail Tuesday (Aug. 2) from Deborah S. Grier, Executive Secretary for the Board of Ethics. Here is that email:

——– Original message ——–

From: Deborah Grier <Deborah.Grier@LA.GOV>

Date: 8/2/16 9:14 AM (GMT-06:00)

To: azspeak@cox.net

Subject: RE: Opinion on Kristy Nichols: Public Records Requests

Good morning, Mr. Aswell:

Pursuant to your public records request of July 29, 2016 regarding an opinion issued by the Board with respect to former Commission of Administration Kristy Nichols’ employment as a lobbyist by Ochsner Health System, please be advised of the following:

A request for an advisory opinion dated November 5, 2015 was submitted by Kimberly L. Robinson with the Jones Walker law firm on behalf of Ochsner Health System and Kristy Nichols.  Ms. Robinson subsequently left the private practice of law and was replaced by R. Gray Sexton as counsel for Ms. Nichols as indicated in correspondence to our office from Mr. Sexton dated December 11, 2015.  On December 16, 2015, a request to withdraw the request for an advisory opinion was submitted to our office.  The Board considered and granted the request to withdraw the request for an advisory opinion at its December 18, 2015 meeting.

 Mr. Sexton, by correspondence dated January 22, 2016, submitted to the Board an Application for Declaratory Opinion on behalf of Ms. Nichols.  A request to withdraw the Application for Declaratory Opinion was received by this office on March 31, 2016.  The Board considered and granted the request to withdraw the Application for Declaratory Opinion at its April 15, 2016 meeting.
No opinion has been rendered by the Board with respect to this issue.
Should you have any questions or need additional information, please do not hesitate to contact me.

Sincerely,
Deborah

Deborah S. Grier
Executive Secretary
Louisiana Board of Ethics

So, what does all that mean?

Could it be that Ochsner and Kristy have decided to let sleeping dogs lie? After all, if she proceeds with lobbying efforts and no one files an official complaint, then it’s no harm, no foul, right? That would certainly run true to form for Jindal’s Gold Standard of Ethics.

A quick check by LouisianaVoice, however, revealed that Kristy is not registered among any of Ochsner Health System’s 10 lobbyists. Sexton told LouisianaVoice today that Ochsner had apparently decided not to pursue the matter and it was his understanding that the company was pursuing “other plans” for Nichols. “Ochsner has a number of other lobbyists,” he said.

So if she is not a registered lobbyist, then just what is it that she does to earn her keep as Vice President of Government and Corporate Affairs?

Or was her employment simply some form of payback as we initially suggested in light of the $31 million Ochsner received in takeover of the Leonard Chabert Medical Center by Southern Regional Medical Corp. and Ochsner as part of Jindal’s haphazard state hospital privatization plan?

https://tomaswell.files.wordpress.com/2015/09/terms-of-the-ochsner-deal-at-leonard-chabert-medical-center.pdf

We’d no sooner received Ms. Grier’s email on Tuesday than the Baton Rouge Advocate posted a couple of stories, also on Tuesday, that caught our eye.

The first involved a claim by Gonzales City Council candidate Wayne Lawson that Ascension Parish President Kenny Matassa and Gonzales businessman Olin Berthelot attempted to bribe him not to seek a city council seat against incumbent Neal Bourque.

The Pelican Post news website first published the report that Matassa and Berthelot had offered Lawson $1,200 and a parish job if he would withdraw from the race. The deadline to withdraw was last Friday (July 29) at noon. Lawson, after posing for a photograph with the cash, a parish job application form and candidate withdrawal forms, returned the money and documents to Berthelot’s office without completing either of the forms.

http://www.theadvocate.com/baton_rouge/news/communities/ascension/article_d9fda80a-58df-11e6-884c-d3779607197c.html

Ricky Babin, District Attorney for the 23rd Judicial District, said his office would investigate Lawson’s claims. He said the Ascension Parish Sheriff’s Office and the Louisiana Attorney General’s Office are also investigating the allegations.

The Attorney General’s Office may be in something of a quandary as it embarks on that investigation, however.

The second Baton Rouge Advocate story, by reporter Gordon Russell, conjured up the ethics complained filed against Iberia Parish Sheriff Louis Ackal.

http://www.theadvocate.com/baton_rouge/news/politics/article_6f7a7990-58e9-11e6-9cd1-a36f0eb42bbf.html

https://tomaswell.files.wordpress.com/2016/03/ethics-complaint.pdf

https://louisianavoice.com/2016/03/03/between-beating-guilty-pleas-sexual-harassment-lawsuit-and-ethics-complaint-iberia-sheriff-louis-ackal-has-his-plate-full/

https://louisianavoice.com/2016/03/09/one-week-after-louisianavoice-story-feds-hand-down-three-count-indictment-of-iberia-parish-sheriff-ackal-top-deputy/

In his story, Russell said that Landry, after trailing incumbent Buddy Caldwell by two percentage points in the primary election for Attorney General last October, received the endorsement of third place finisher Geri Broussard Baloney of Garyville in St. John the Baptist Parish, who had polled 18 percent.

With her endorsement in his back pocket, Landry, a former U.S. Representative, easily won the November runoff over Caldwell (who can forget Caldwell’s concession speech?). Soon thereafter, Baloney’s daughter, Quendi Baloney, was given a $53,000-a-year job by Landry.

At the time of her hire, all would-be employees of the AG’s office were required to sign a form agreeing to background checks and were also asked, in writing, if they had any criminal record.

In her case, she did. In 1999, she was charged with 11 felony counts of credit card fraud and theft, eventually pleading guilty to three counts, according to court records from Henrico County, Virginia. She was sentenced to six years in prison, all of it suspended.

Her new job? Well, it’s in the AG’s fraud section. More irony.

But in the end, her background is of less interest, given that her conviction was 17 years ago, than the fact that she was given her job as apparent payback for her mom’s endorsement of Landry following the first primary election in October.

A spokesperson for the AG’s office, Russell wrote, did not respond to questions about whether other candidates had applied for Quendi Baloney’s job or whether Landry had hired any other convicted felons.

For her part, Quendi Baloney told The Advocate that her arrest and conviction were “devastating,” but had made her a “stronger, harder-working ethical adult…”

She forwarded to The Advocate a link to the state’s new “Ban the Box” law which prevents state agencies from asking applicants about their criminal records. That law, however, did not take effect until after she was hired.

It’s going to be more than a little interesting to see how Landry’s investigation of Matassa and Berthelot unfolds in light of the same day’s revelations about his own actions.

But we’re willing to wager that when the dust settles on the issues of Matassa, Berthelot, Nichols, Ackal (the state ethics complaint, not the federal indictment) and Baloney, we’ll still be able to say:

Nothing gets done.

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In his message in the Louisiana State Board of Dentistry’s Winter 2010 Bulletin, retiring board President Barry Ogden said in the third paragraph from the bottom of page 4 of the bulletin: “Every time a licensee gets sanctioned they always explain it as the board was on a witch hunt… or they are power hungry…. This is all bogus, and I ask you whether your would sign a consent decree if you thought we were wrong? I don’t think so.”

http://www.lsbd.org/Bulletins/Bulletin2010.pdf

It’s pretty obvious why: The board holds the life or death power over dentists’ livelihoods. They can, on a whim, render years of costly education useless, destroying careers in the process.

LouisianaVoice has shown in previous posts how the Louisiana State Board of Dentistry has run roughshod over dentists. We have revealed board actions ranging from levying draconian fines for minor board rules infractions to initiating devastating reprisals against whistleblowers and those who otherwise resist its strong-arm tactics.

But in examining the case of Slidell dentist Dr. Kenneth O. Starling, it becomes even more evident that the Dentistry Board for decades has operated a white collar extortion scheme that rivals any protections racket run by mobsters in New York, New Jersey or elsewhere.

Strong accusation? Indeed. But what’s more, the board has been allowed to do this at will, unabated and unrestrained by those who appoint the board members. And that would be whoever happens to occupy the governor’s office.

Due process? Fugetaboutit. Innocent until proven guilty? Not even an option. Burden of proof? Don’t want it, don’t need it, can’t use it.

To be sure, some of Dr. Starling’s troubles were of his own making. He had a drinking problem that first placed him in the board’s crosshairs. He freely admits that and has never made an issue of it.

But then, as it often does, the board smelled not alcohol, but blood.

And, like any other rapacious animal, sensing weakness on the part of its prey, it moved in for the kill.

In early 2010, he was called before the board for his “habitual indulgence of the use of drugs, narcotics, and intoxicating liquors” in violation of state statutes and for failing to notify the board of three driving while intoxicated convictions.

The statute was a catch-all one and while it could be interpreted that he was simultaneously abusing narcotics and/or other drugs, he insists he was not. The term “habitual indulgence,” however, seemed accurate enough in light of three DWIs. “I did abuse alcohol and I did receive three DWIs,” he said in a recent interview with LouisianaVoice. “I own them and I acknowledge that fact.”

On March 5, 2010, Starling signed a consent decree in which he agreed to “reimburse the board costs” of $350 and to pay a fine of $8,000 to the board. In addition, a five-year suspension of his dental license was stayed (waived) in favor of a five-year probationary period provided he satisfactorily completed an approved rehabilitation program.

A third major stipulation of the consent decree was that Starling would surrender “all controlled dangerous substance prescribing privileges.” That meant just what it said: he could not prescribe medications during the five years he was on probation.

So, with the consent decree signed, his $8,000 fine paid, and his DEA card (his only authority to issue prescriptions) cancelled for five years, he shuttled off to his new residence for six months at the Palmetto Addiction Recovery Center 200 miles away in Rayville in Richland Parish in Northeast Louisiana. http://www.palmettocenter.com/

And that’s when his real problems began.

During his exile in Palmetto, three other dentists rotated with each other to fill in for Starling. The three on occasion prescribed pain medication like Vicodin and Lortab to patients.

Those were perfectly legal because it was they, not Starling, who issued the prescriptions.

Except because they were written on prescription pads from his dentist office, the pharmacies filling the prescriptions, instead of looking at the signature on the prescriptions, looked at the letterhead on the pads and entered Starling’s name as the prescribing dentist. That information was entered into a data bank used by pharmacists as a deterrent to doctor shopping by those addicted to pain killers.

And that’s where Camp Morrison entered the picture and things got unbelievably complicated for Starling at the hands of a Board of Dentistry that had already long been drunk on power.

Morrison was a private investigator who was issued eight contracts by the Board of Dentistry totaling more than $1.46 million. Even more puzzling was how Morrison, a private contractor, warranted free office space in the board’s suite of offices on the 26th floor of One Canal Place in New Orleans—for which the board pays $4,700 in monthly rent.

Beginning with a $45,000 contract in 1997, all but one of his contracts were of three-year durations. His final contract, for $110,000, was for only 10 months, from September 1, 2012 through June 30, 2013. https://wwwcfprd.doa.louisiana.gov/latrac/contracts/expiredSearchResults.cfm?view=A

Out of the blue and based on an “investigation” by Morrison, Starling was accused by the board of dispensing prescription narcotics against the terms of his probation.

Starling said it would have been impossible for him to issue prescriptions with no DEA identification card, so he said he asked Morrison how he got his information. “He said, ‘I had a hunch and I looked it up,’” he quoted Morrison as replying.

The only problem with that is that Morrison, who has no DEA credentials, had no legal authority to access the data bank. “He had to have accessed the information by obtaining someone’s DEA card,” Starling said. “That’s a flagrant violation of the Computer Fraud and Abuse Act, a federal offense. He also ran me through the DEA data base and the FBI data base.

“He had a hunch and he looked up information that was not only illegal, but inaccurate as well,” he said. “I have never had any prescription drug issues.”

In Massachusetts, a doctor named Bharani Padmanabhan has filed a lawsuit against the Massachusetts Attorney General in federal court for “illegally trawling through the state prescription drug monitoring program.”

http://maurabrokecfaa.com/

DOWNLOAD CASE # 1:15-CV-13297-NMG

Besides the prescriptions written by the three substitute dentists—verified in at least one case by a March 18, 2010, letter from a Walgreens pharmacist—six of the 10 prescriptions Morrison accused Starling of writing illegally were actually written prior to Starling’s surrender of his DEA card at the end of October 2009.

So it turns out that six prescriptions were written legally while Starling still held his DEA card and the remaining four in question were written by substitute dentists working to keep his office open while he was in rehab.

Starling, of course, did what anyone in his position would do. He fired off a letter to Morrison. “Since my voluntary surrender of my DEA license, I have neither written, nor authorized to be written, nor called in, any prescriptions for controlled substances,” he wrote.

Besides including a copy of the letter from the Walgreens pharmacist, he named the substitute dentists who wrote prescriptions for each of the patients cited by.

“I was under the understanding that without a DEA license, no prescriptions could be filled under my old DEA number,” he wrote.

And here’s where things really got dicey.

On Nov. 5, 2013, the Board of Dentistry sent Starling a letter inviting him to a December 6 conference of the board’s Disciplinary Committee “relative to your request for reconsideration of adverse sanctions.”

Those sanctions proposed an additional fine of $20,000, plus $850 in costs to cover Morrison’s error-laden “investigation.” Among the erroneous allegations was the claim that Starling wrote a prescription for 300 tablets of Hydrocodone when in reality, it was for a much weaker dosage of 300 mls. (about 60 teaspoons) of the medication in liquid form.

That Dec. 6 conference was attended by committee Chairman Blackwood, Drs. David Melancon and Wilton Guillory, Jr., and independent counsel Arthur Hickham, Jr.

The minutes of that meeting read, in part:

“The Disciplinary Committee of the Louisiana State Board of Dentistry finds that the application for reconsideration of an adverse sanctions filed by Dr. Kenneth Starling does have substantial merit. (Emphasis added.)

In a separate letter to the Board of Dentistry, Starling enclosed copies of patient records that showed signatures of substitute dentists on the dates on which Morrison accused him of writing the prescriptions. “I did not see any patients during the dates I was incarcerated in St. Tammany (Parish) or in treatment at Palmetto treatment center and no prescriptions were written by me during this time.

“I ask that the Board take all of this into consideration and I humbly ask for a reconsideration of sanctions imposed in relation to the second consent decree.”

And it was that last sentence, however, that spelled doom for Starling at that Dec. 6 committee meeting. A “reconsideration of sanctions” would necessarily mean a rescission of the $20,000 fine and the $850 in costs.

And the board was having none of that.

With the Dentistry Board, money trumps justice. Every time.

The very next day, on Dec. 7, the full board met and besides approving pay raises and per diem payments and other expenses to themselves, and despite the Disciplinary Committee’s decision that Starling’s application had “substantial merit,” voted unanimously to deny Starling’s application for reconsideration.

Starling was called in and Blackwood pushed the newest consent decree toward him and instructed him to sign it.

So, even though the Disciplinary Committee recommended consideration of Starling’s application, the full board not only denied the application on the following day, but also had the consent decree already drawn up, obviously in advance of the board’s decision.

It was a kangaroo court and the fix was in.

The consent decree not only called for him to pay $20,850 in fines and costs, but to again surrender his DEA card, attend AA meetings, enter into group therapy, undergo addiction counseling, re-enter Palmetto, and to agree to five years’ probation.

Starling balked and Blackwood, he said, spat “Sign the G—d—m consent decree.”

Realizing that Blackw00d and the board held all the cards, Starling signed.

Justice, or more accurately, the board’s idea of justice, was served and the Starling’s bank account was $20,850 lighter.

And the citizens of Louisiana were safer, thanks to the diligence—and greed—of the State Board of Dentistry.

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There are times when we have to dig pretty deep to uncover wrongdoing, conflicts of interest, favoritism, and outright corruption. There are other times when the information just seems to drop into our lap.

Such is the ongoing reports of kangaroo court proceedings conducted by the Louisiana State Board of Dentistry. And how was a witness in a case against a fellow dentist rewarded with a seat on the board? And how is that dentist/board member allowed to serve as an insurance claims analyst in determining payments to other dentists in the same geographic area of his own practice?

It’s probably a good idea to provide something of a refresher to bring new readers up to speed. The State Dentistry Board previously had a contract with a private investigator who had a nasty habit of deciding that a dentist was in violation of some obscure regulation and then going about his investigation with the intent of proving his pre-set theory.

Investigator Camp Morrison, who racked up hundreds of thousands of dollars in billings while contracted to the board for more than two decades (he even was provided rent-free office space in the Dentistry Board’s office suite on Canal Street in New Orleans), appeared to have an unlimited expense account.

And why not? He roamed the state under color of law, harassing dentists to self-generate his own fees which were more than paid for by the six-figure fines levied against dentists not in the board’s favor.

Of course, he couldn’t have done all that without the aid of the board’s general counsel, who often served in dual capacity as board counsel and board prosecutor, a violation of legal ethics rules and common sense. Because he only had a duty to his client the board of dentistry to act in its best interest, anyone that he prosecuted was denied due process. The same would be true if a police force handled its own prosecutions without an independent prosecutor; there would be no fundamental perception of fairness.

Attorney Brian Begue was also known to hide behind the cloak of administrative law in denying defendants’ rights afforded under the US Constitution. Because he self-generated his own fees, he had apparently selfish financial motives for seeing dentists prosecuted. In 2012, he was found by the Louisiana 4th Circuit Court of Appeals to have violated the due process of a Louisiana dentist. https://louisianavoice.com/2015/11/16/dentistry-board-facing-difficult-future-because-of-policies-contracts-with-attorney-private-investigator-are-cancelled/

This investigator and attorney were perhaps given cover by a few complicit board members and staff to carry out their harassment and extortion schemes.

Take Dr. Isaac “Ike” House of Haughton in Bossier Parish. http://www.lsbd.org/boardinfo.htm

In a highly questionable move by the Jindal administration after he testified as a witness in a hearing in which a Louisiana dentist alleged the board participated in criminal conspiracy and unfair trade practices against him by revoking his license to practice in Louisiana.

Was that appointment his reward for his testimony against the dentist?

Dr. Ike, it seems, wears many hats: he’s a dentist, a witness, a board member, and more recently, it has been learned, an analyst for dental insurance claims for a Baton Rouge dental insurance company.

IMAG2140

DENTAL INSURANCE CLAIM ANALYSIS PERFORMED BY DENTAL BOARD MEMBER DR. ISAAC “IKE” HOUSE (CLICK ON IMAGE TO ENLARGE)

            That last position might appear to some as something of a conflict. As one who performs evaluations of claims for an insurance company serving dentists in his geographic area, he has direct input on their financial reimbursement from the company.

But conflicts of interest have never been a deterrent to the board in the past. The questionable practices of Begue and Morrison is ample evidence of that.

One former Shreveport dentist, Dr. Ryan Haygood, fought the board for several years and finally settled with the board early last month.

Dr. Haygood settled for a fine of $16,500, a fraction of what the board unjustly cost him in its ongoing persecution. Haygood’s attorney told him the facts of life about a board hearing that was cancelled at the last moment after the settlement agreement was reached: the deck was stacked against him and he would lose at the hearing—and it would cost him much more than the $16,500. The board was raising the same issues as before and daring him to appeal. He said he did not have the $300,000 necessary to go through with the appeal, only to lose since the board itself decides all appeals of its decisions.

He said there was no confidentiality clause in the agreement but two of the stipulations of the agreement were that he would take his Internet blog down and that he would sign a “non-disparaging clause.”

LouisianaVoice, however, is not bound by any such restrictions and our blog is still up and we will continue to disparage when deemed appropriate.

Haygood, however, is moving forward with his civil lawsuit against the board which will ultimately be determined in a court of law and not in the Dentistry Board’s hearing room by an attorney who acts as accuser and judge.

Meanwhile, rumors of state and federal investigations persist. http://theadso.org/federal-racketeering-laws-may-finally-bring-the-dental-board-to-its-knees/

It would be most refreshing if investigators could offer a valid explanation of how certain boards’ powers to run roughshod over licensees has been allowed to go unchecked for so long

If there’s corruption, this must be Louisiana (with apologies to the 1969 movie If It’s Tuesday, This Must Be Belgium).

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LouisianaVoice has obtained documents which reveal that a doctor at the Veterans Administration Medical Center in Alexandria, LA. was denied a license in Florida because she had previously falsified medical records while employed at a hospital in Maryland.

The records from Maryland were provided subsequent to our story on Wednesday that examined numerous complaints about Dr. Shivani Negi over her confrontations with hospital staff members and families of patients. https://louisianavoice.com/2016/06/29/cenla-media-ignore-elephant-in-the-room-alexandria-va-hospital-rife-with-controversy-swirling-around-one-doctor/

LouisianaVoice has also learned that the U.S. Attorney’s office, which normally would investigate and possibly prosecute cases of criminal wrongdoing, instead provided a legal defense for Dr. Negi in a civil lawsuit brought against her in federal court by the family of one patient who died in her care. That would make it all but impossible for that same U.S. Attorney to take part in any prosecution of the doctor should it be determined later that there might have been criminal neglect involved in the deaths of several patients at the hospital.

Dr. Negi has been the subject of repeated criticism for rude behavior and for the manner in which she is said to insist on the signing of “Do Not Resuscitate” orders by family members of other elderly patients.

She was denied a medical license by the Florida Board of Medicine in September 2003. LouisianaVoice reported on Wednesday that the board’s minutes reflected that the committee “discussed in length the seriousness of the issue” and that Dr. Negi “gave a brief history of events” but that the minutes failed to provide any details of the “event” or “issue.” REFUSED HER APPLICATION

(LEFT CLICK ON IMAGES TWICE TO ENLARGE)

Since then, additional documents have surfaced that show that Dr. Negi falsified medical records while working at Maryland General Hospital in Baltimore in December 2000 and then lied about her actions when confronted by an ad hoc committee formed to investigate the incident.

Saying that she exercised both bad judgment and unethical behavior when she “inappropriately altered the medical record,” she was ordered by the chairman of the hospital’s Department of Medicine to attend an education program for appropriate medical record keeping, medical ethics, and proper professional behavior. “Your participation in this program is mandatory,” said Dr. William C. Anthony in a May 1, 2001, letter to her. LETTER OF REPRIMAND

The issue arose when a nurse filed an incident report regarding the events of Dec. 6, 2000. The nurse said she photocopied the chart Administration Order Sheet “sometime after 2:30 a.m.” on that date in order to attach it to the patient’s Risk Occurrence Report that she was completing. MARYLAND HOSPITAL LETTERMARYLAND HOSPITAL LETTER PAGE 2

Several days later, the nurse, Rhonda Calhoun, reviewed the order form and noticed a discrepancy in that orders for hourly blood cultures “had been added to the physician’s order form sometime after Dec. 6, 2000, 2:50 a.m.”

She said she was certain that the orders were entered after the original order “because the order does not appear on the photocopy she made for attachment to the Risk Occurrence Report.” Moreover, she told the ad hoc committee that she was present when Dr. Negi wrote orders at 10 p.m. and that she watched Dr. Negi write orders concerning the patient’s temperature “and observed her write ‘do not call me’ and then cross it out and change it to ‘let HO know.’”

It was not immediately clear what “HO” referred to, but Calhoun told the committee she was positive that Dr. Negi did not write the order for blood cultures at that time. She insisted that the order for blood cultures was not on the order sheet when she entered the orders into the computer at 2:50 a.m. on Dec. 6.

Dr. Negi was then called before the committee and proceeded to claim “emphatically” that she wrote it at 10 p.m. on Dec. 5, the ad hoc committee report says.

She was shown a copy of the final charter order that included her order for the blood cultures and then she was shown the photo copy of the chart order form that included “all orders through December 6, 2000, 2:30 a.m., but (which) does not include any orders for blood cultures. She continued to insist that she wrote the orders for blood cultures at the same time she wrote the orders to be called by the nurse in case of elevated patient temperatures. She said he had no explanation for why the photocopy did not contain her order for blood cultures.

She was then asked if she wished to make any other commits to the committee, but she declined and was excused.

In its report, the ad hoc commit said Dr. Negi’s explanation “is not plausible. The committee believes Dr. Negi inappropriately altered the medical records after the fact by adding her order for blood cultures to the charter order sheet sometime after” 2:30 a.m. Dec. 6, 2000, and by “trying to make it appear” as though it was written at 10 p.m. on Dec. 5.

“Furthermore, the committee is dismayed by Dr. Negi’s inability or unwillingness to admit to this inappropriate alteration of the medical records. The committee unanimously agreed that this inappropriate alteration of the medical record, and the physician’s implausible response to our questioning, reflect not only bad judgment, but also unethical behavior.”

Among the grounds for denial of a medical license in Florida is “Making deceptive, untrue, or fraudulent representations in or related to the practice of medicine or employing a trick or scheme in the practice of medicine.” This apparently was the hook on which the State of Florida hung its denial of a medical license to Dr. Negi on September 13, 2003.

GROUNDS FOR DISCIPLINE

REASONS FOR DISCIPLINE

She then applied to and was granted a medical license by the Commonwealth of Virginia, one of only a handful of states which licenses graduates of foreign medical schools. That license was granted effective Nov. 13, 2003.

Dr. Negi is a graduate of Ross University School of Medicine in the Caribbean island nation of Dominica. Though Illinois-based DeVry University has since taken over the school, it still is not accredited by the Association of American Medical Colleges. http://www.bloomberg.com/news/articles/2013-09-10/devry-lures-medical-school-rejects-as-taxpayers-fund-debt

On her Florida application, Dr. Negi was asked “Have you had any application for professional license or any application to practice medicine denied by any state board or other governmental agency of any state, territory, or country.” She checked “No” to that question.

On her Virginia application, however, she failed to even respond yes or no to a similar question: “Have you ever been denied a license or privilege of taking a license/competency examination by any licensing authority?” Instead, she wrote, “I had applied for a Florida license but changed my mind and did withdraw my application.”

VIRGINIA QUESTIONNAIRE

APPLIED FOR A FLORIDA LICENSE

Her Florida application, however, was not withdrawn until June 8, 2006, more than two and one-half years after Virginia issued her a license in November 2003 and 33 months after her Florida application was denied.

So, Dr. Negi is on record as having lied about altering medical records while employed at Maryland General in December 2000 and again when applying for her medical licenses in Virginia after having been denied a license in Florida.

All of which raises a few obvious questions that come immediately to mind:

  • Who vets doctors for vets at the VA?
  • What can be done about Dr. Negi at this point in time?
  • Given this latest information, along with what we’ve been hearing about the VA, would you allow your loved one to be treated at a VA hospital?

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For the embodiment of what has happened to the newspaper industry and to erstwhile good, hard-hitting investigative reporting, one need look no further than the Alexandria Town Talk.

It’s not that The Town Talk, one of five Gannett-owned newspapers in Louisiana and one of 123 Gannett publications in the U.S., Guam, and the United Kingdom, is necessarily the poster child for the fast-food media genre. But when a newspaper ignores a major news story all but gift-wrapped and dropped in its lap, it unavoidably becomes a microcosm for all that’s ailing the once robust medium.

So, what’s this big story that The Town Talk and other area media were repeatedly called about but chose not to pursue?

That would be the Veterans Administration Medical Center in Alexandria.

It’s not that the problems of veterans obtaining medical treatment from the VA has been hiding under a rock. It’s a national disgrace and it’s well documented that while the rest of the country is politely offering an empty, robotic “Thank you for your service” to our military, it begins to take on a hollow ring as our nation’s leaders continue to send our young men and women into harm’s way only to discard them when they return with missing limbs, closed head injuries, psychological disorders and PTSD. They’re quietly shunted aside and forgotten. The Pentagon, it seems, has little use for damaged merchandise—unless it’s a billion-dollar aircraft that won’t fly built by a defense contractor (read: campaign contributor) favored by some powerful member of Congress.

When a friend, a career soldier, was diagnosed with pancreatic cancer a few years ago, he was promptly discharged before he could qualify for his pension. Thank you for your service.

The horror stories of long waits for treatment and refusals of benefits and medication are by now well-known and it is no different at the Alexandria VA Medical Center.

But it is at that medical center that the stories become almost macabre in nature. And they all seem to revolve around a single doctor, Dr. Shivani Negi.

Here’s what we know about Dr. Negi:

  • The families of several patients have signed affidavits attesting to her callous treatment of patients and her insistence that family members allow patients to die without attempts at resuscitation;
  • Those same grief-laden affidavits describe in detail how abusive and non-communicative Dr. Negi becomes when families refused to sign “Do Not Resuscitate” (DNR) forms;
  • Some family members said in their affidavits that they believed Dr. Negi allowed their loved ones to die deliberately and that she purposely removed them from the intensive care unit (ICU) to a remote room on another floor without benefit of one-on-one care normally given critical patients;
  • Other doctors and nurses have provided written statements or testified in depositions as to her inappropriate remarks in the presence of family members and patients;
  • The same doctors and nurses describe her violent temper and her threats to “kick butts” of subordinates;

The Commonwealth of Virginia granted her license to practice medicine after she testified she had never been refused a license elsewhere and that she had withdrawn her application in Florida. The only problem was Florida had actually refused her application a full two months prior to Virginia’s awarding her a license. Her Florida application, however, was not withdrawn until 2006.

The minutes of the Florida Board of Medicine’s Credential Committee of Sept. 13, 2003, provide little insight as to the reasons for the  denial of her license application but do hint at some problem in Dr. Negi’s professional past.

“The applicant (Negi) was present and sworn in by the court reporters,” the minutes begin. “The applicant gave a brief history of events. The Committee discussed in length the seriousness of the issue. Dr. Tucker made a motion to deny the (application). The motion was seconded by Dr. Avila. The motion failed with Dr. Miguel, Dr. Davies and Mr. Dyches opposing. Dr. Davies made a new motion to deny the application…and allow 14 days to withdraw. The motion was seconded by Dr. Miguel. The motion passed unanimously.” REFUSED HER APPLICATION

The Florida statutes on which the application rejection was based were identical in both motions with only the provision to allow 14 days for Dr. Negi to withdraw added to the second motion.

There was no explanation of the “history of events” given by Negi, nor the circumstances of those “events.” Nor was there any explanation of the “issue” described deemed by the committee to be a serious sticking point in the consideration of her application.

The problem, however, could have been with the medical school she attended, Ross University School of Medicine (RUSM) in the Caribbean island nation of Dominica which was not accredited by the Association of American Medical Colleges, the body that approves medical programs in the U.S. as of September 2013, according to a story by Bloomberg Markets. http://www.bloomberg.com/news/articles/2013-09-10/devry-lures-medical-school-rejects-as-taxpayers-fund-debt

RUSM has since been taken over by Illinois-based DeVry University which Bloomberg says accepts students rejected by U.S. medical colleges. And even though it is a for-profit school, U.S. taxpayers pick up the tab for about 34 to 48 percent of students who default on their student loans which average about $250,000 compared to $170,000 for graduates of U.S. medical schools.

On her Florida application, a copy of which was obtained by LouisianaVoice, there were a series of questions and blocks to check for the appropriate “yes” or “no” answers.

For the question “Have you ever been dropped, suspended, placed on probation, expelled or requested to resign from any school, college or university,” she first checked “Yes” but scratched that answer out and checked “No.”

On another page further into her Florida application, she also checked “No” to the question: “Have you had any application for professional license or any application to practice medicine denied by any state board or other governmental agency of any state, territory, or country?”

Virginia apparently asks a similar question on its application forms because Dr. Negi submitted an “Addendum to questions 14 and 15” which said, “I had applied for a Florida license but changed my mind and did withdraw my application.” APPLIED FOR A FLORIDA LICENSE

There is a problem with the timeline on that answer, however. LouisianaVoice has copies of a document from Florida Regulatory Specialist Cherise Davis which indicates Dr. Negi did not withdraw her application until June 8, 2006, nearly three years after her license was issued by Virginia.

In the case of Floyd Hamilton, Jr., a Bronze Star recipient who died in 2009, there are many questions but few answers.

Hamilton, 85 died at the hospital in 2009, nearly three years after Dr. Negi removed him from ICU to a room on another floor and far from the nurses’ station and without the ventilator support necessary, in the view of one physician who was involved in a verbal exchange with Dr. Negi when he attempted to treat Hamilton. Hamilton’s son claims his father suffered irreparable brain damage from the removal of the ventilator.

At least two other doctors at the VA hospital, as well as other staff members, have taken issue with both Dr. Negi’s medical decisions and her attitude toward patients and co-workers.

Dr. John Sams said he responded to a code for another patient on July 19, 2011, and found him “minimally breathing.” He initiated treatment and the patient’s pulse became stronger and he began to stabilize. SIGNED REPORT

“More than five minutes after I arrived, Dr. Negi made her appearance,” he wrote in his signed report. “With no assessment of the situation, she immediately ordered me to return to the (Express Treatment Unit) and rudely told me I was not to leave the ETU for CLC (Community Living Center, or VA nursing homes) codes. She was temporary Chief of Medicine at the time, my boss,” he wrote.

“I returned to ETU…and upon entering found that the patient was being rolled into a bay. He was unaccompanied by Dr. Negi, who was soon pounding on the ETU door for admission. He (Hamilton) had lost his pulse. Chest compressions were begun.

“No attempt at intubation was allowed by Dr. Negi. Finally, I reordered and received a laryngoscope tube and easily intubated the patient. During the mayhem by Dr. Negi, she verbally terrorized the ETU. While I was doing the chest compressions, Dr. Negi vulgarly stated to me, ‘Sams, you’re doing them too slow. Do them like a young married man—hard, deep and fast.’”

Dr. Sams wrote that Hamilton did not respond to resuscitative efforts and Dr. Negi “asked if anyone had any suggestions prior to ending the code.” Sams said he said he would like to obtain an arterial blood gas (ABG)—a procedure to determine how well the lungs are moving oxygen into the bloodstream. “She left the code to sit down, mocking the suggestion with a derogatory comment. She continued to shower us with her inappropriate comments until the ABG returned. The date was (sic) not helpful and resuscitative efforts were stopped. At that time, I informed Dr. Negi that never in the future would I tolerate her unacceptable behavior.”

Dr. Sams said he reported the incident in writing to his director supervisor who, instead of taking action against Dr. Negi, reprimanded Sams for responding to the CLC code.

Dr. Mark St. Cyr, an emergency room contract physician, testified in a deposition that he had a conflict with Dr. Negi from the first moment they met. He said Dr. Negi threatened to “kick my butt” after he sought permission to admit an ER patient into the hospital. His deposition was given in a lawsuit by Floyd Hamilton, III, the deceased patient’s son.

He said the younger Hamilton gave specific instructions that he wanted his father kept in ICU and that the family “wanted everything possible done” to keep his father alive—and that he did not wish to sign a Do Not Resuscitate (DNR) order.

Attorney Robert Evans, III, indicated in the deposition of Dr. St. Cyr that he had been in communication with the families of several patients of Dr. Negi “who believe that their family members have died from her treatment.” COMMUNICATION WITH FAMILIES

Floyd Hamilton, III, as did family members of other patients, said Dr. Negi became incensed and abusive when her requests for DNR orders were not signed by family members. Hamilton said she even stopped communicating with him and would not return his calls.

Documents showed that Dr. Negi even sent a $50 money order to one woman in Leesville so that she could travel to Alexandria to sign a DNR order.

Dr. St. Cyr said Dr. Negi’s decision to remove a tube protecting his airway was not consistent with the family’s wishes. Asked in his deposition of removing the tube was not consistent with the family’s request to do everything possible, Dr. St. Cyr responded, “That’s a fair statement.” THAT'S A FAIR STATEMENT

St. Cyr described Dr. Negi as “aggressive” in terms of “getting patients in and getting them out” of the hospital. “(If) she doesn’t feel like something is worth it, she may not be quite as aggressive medically in terms of performing certain actions,” he said.

When asked by attorney Evans if “she might put him somewhere and take out the tube to expedite his demise,” Dr. St. Cyr again replied, “It’s a fair statement.” EXPEDITE HIS DEMISE

That line of questioning developed over St. Cyr’s description of how Dr. Negi removed the elder Hamilton from ICU to another floor at the end of a hall furthest from the nurses’ station. “Why would he (Hamilton) go to the floor, the last room at the end of the hallway (when he) can’t press a button, can’t call a nurse, or anything, and he’s not even responsive?” he asked. “You’re literally putting the person out there to die.”

Asked if any other hospital personnel were involved in the removal of the intubation of Hamilton, Dr. St. Cyr said, “No, sir. That’s solely Dr. Negi. When a person’s in the intensive care unit, Dr. Negi was in charge and you don’t go against Dr. Negi.”

Two nurses also filed written reports of the confrontation involving Dr. Negi and Dr. Sams, both claiming that Dr. Negi was yelling, belligerent, unprofessional, and throwing her gloves. “…She stated, ‘You never stop CPR,’” one of the nurses quoted her as saying. “CPR was never stopped on the vet other than when Dr. Negi was doing CPR.” The same nurse said Dr. Negi “continued to berate Dr. Sams” because Dr. Sams wanted a blood gas. Dr. Negi made the comment to respiratory, ‘Well I guess you will get to practice your collection of blood gases.’”

The Calcasieu Parish District Attorney, in a letter to his counterpart in Rapides, intimated that had the events involving Hamilton occurred in Calcasieu, “I would certainly immediately provoke an investigation by law enforcement, or possibly a grand jury, to investigate allegations against this doctor.”

D.A. John Derosier, in his Dec. 23, 2014, letter to Rapides D.A. Phillip Terrell, Jr., wrote, “Please have someone…determine whether or not there is sufficient basis to move forward with a formal investigation.”

 

LETTER TO HIS COUNTERPART

D.A. LETTER PAGE 2

Terrell, claiming his office was not equipped for such an extensive investigation, asked for assistant from then-Attorney General Buddy Caldwell’s office and Assistant Attorney General Arthur Ogea of Lake Charles was given the assignment.

Jeff Landry, upon taking office as Caldwell’s successor, however, fired Ogea and seized all his records on the Hamilton case. Contacted by LouisianaVoice, Ogea agreed to talk in more detail about his thoughts in the coming days but did say he felt there was sufficient evidence for a grand jury investigation and possible charges of negligent homicide against Negi.

It will be interesting to see how Louisiana’s new attorney general proceeds with this investigation.

Floyd Hamilton, III, meanwhile, kept applying pressure by picketing the hospital and by notifying members of Louisiana’s congressional delegation and VA officials.

Because he took photographs of his father that showed the stark contrast between the elder Hamilton’s condition before and after being removed from ICU, there is now a sign posted at the VA Hospital in Alexandria proclaiming an absurd—and unenforceable—rule that photographs are no longer allowed at the facility.

The Department of Veterans Affairs, Office of Inspector General, conducted an investigation of “suspicious deaths” at the Alexandria VA hospital. In its executive summary dated Feb. 14, 2008, the OIG repeatedly—and predictably—said that investigators “did not substantiate” any of the allegations involving Hamilton or any of several other patients who died while in the care of Dr. Negi.

Five days later, Christina Lavine, director of the VA’s Hotline Division, wrote Hamilton’s son, Floyd Hamilton, III to say that the VA OIG had closed his father’s case. “As we advised you when we opened this case, our decision to close a Hotline case is final, and there are no appeal rights,” she wrote.

Instead of definitive, meaningful action, all we’re received so far are insincere apologies and empty promises that conditions will improve. But they never do.

A congressional subcommittee held hearings on the Alexandria VA Hospital only last week. Even though subcommittee members were well aware of irregularities pointed out by Floyd Hamilton, III, and even though he was in attendance at the hearing, he was never allowed to testify. Perhaps, to borrow a phrase from Al Gore, Hamilton’s claims constituted “an inconvenient truth” to officials who should be infuriated at the manner in which our veterans are treated upon their return from duty.

 

 

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