Dr Jan’s Blog Novel-Correcting the Record

Further examination of Harwell’s letter (page 2, item 2) states that “an accusation is already on file against Dr Adams”. Figure 25 is a photocopy of that complaint. It is an allegation, written on a Medical Board of California Consumer Complaint Form, dated the 18 November, 2007.

Now granted, I have yet to appear on Larry King Live, so in fact they have no complaint, but more importantly, it is signed by none other than Stephan Scoggins, Donda West’s nephew, someone already willing to demonstrate (and has) that he is prepared to lie to the Coroner’s investigater in order to hide what I believe is his criminal negligence in his aunt’s death. They were complaining to the medical Board that I was not giving them information, eleven days before they requested it. (I’m sure this is why detectives like their jobs.)

Now Ms. Johnston is under no obligation to discuss with me or any other physician for that matter, who she does or doesn’t know. But Ms. Johnston, in her capacity as Executive Director of the MBC does have a duty of candor. Nevertheless, my purpose here was not to single out Ms. Johnston. (Indeed, Bernie Karmatz is a hundred times worse.) It does however demonstrate a pattern of behavior coming out of the Medical Board of California, one of lies and harassment of physicians, and abuse of power. No one knew at the time what had really happened to Donda West. And the authorities who had had an opportunity to review the chart all knew that the information in the press was coming from the family of Donda West and her attorneys. They knew it because it was all wrong. The data in the press was wrong. They knew it wasn’t coming from me, but they continued to “flex” for the cameras.

Let’s take a closer look at the behavior of these attorneys by examining their letter to the Medical Board. Keep in mind that they were “supposedly” hired to protect the interests “of the estate of Donda West and the surviving family members”. That surviving family member is Kanye West, and only Kanye West. Stephan Scoggins has no legal authority to represent her estate and a review of court filings in Los Angeles demonstrate that Donda West died inestate and that Kanye, himself, didn’t legally have authority until March of 2008. So why were they protecting Scoggins? And why was the press ignoring the inconsistencies? The only answer is meanness.

Harvey Levin, for his part, was committed to his personal attacks on me. He had long ago abandoned Donda West. He suggested that malpractice suits filed by patients were related to my training as a surgeon. It seemed important at the time to imply that malpractice suits demonstrated a pattern. They do. However, once again, Harvey was so intent on “gotcha journalism”that he missed it.

 These suits not only represent an abomination perpetrated against me; they are a symbol of the foulness that has contaminated our entire society. Evaluation shows all of them to be without merit. Harvey was again presenting only half of the story in an attempt to support his uninformed position.

In those instances where the patient (or the doctor) thought a scar could be improved or further refinement might be in order, a problem arose. The patient had no money to cover operating room costs. The only recourse, in their minds, was to use legal force to compel doctors to do it for nothing. (I will allow also that some people are just underhanded and will always try to get something for nothing. That, however, does not represent malpractice on the part of the doctor.)

At any given moment in the United States, there are 60,000 open medical malpractice cases involving about 700,000 physicians. Furthermore, as noted by Jeff Segal, M.D., the CEO of Medical Justice News, “The national practitioner databank includes the names of over 200,000 healthcare professionals who have not only been sued but have paid a settlement or judgment. So, being sued, as noted by Dr. Segal, is hardly an indictment of incompetence, although the media would have you believe otherwise.”  There’s even more incentive if your doctor is the guy on TV.

When these suits occur, you will find that the plaintiff’s attorney sues a host of people – the anesthesiologist, the surgery center, and the surgeons – all at once in an effort to divide and conquer and also get the most money for his work. During these procedures, the plaintiff’s attorney provides a paid expert who argues that the treatment in his opinion is below the standard of care. The defense, on the other hand, pays an expert who says, “No, I’ve reviewed this case and the level of care is not below the standard.”  I suggested to Mr. Levin that he do his own research and contact the attorneys representing neither the plaintiff nor the defendant but the surgery center. The attorney representing the surgery center in every case I’ve been associated with has called my attorney and confessed that in spite of all this, their group of experts has never found that Dr. Adams’ care was below the standard of care; in other words, the suits were frivolous and unfounded.

There is, however, one case that deserves a personal comment. There was a patient who had won a judgment allegedly due to a sponge having been left in a breast pocket at the time of placement of breast implants. I say allegedly because the case never went to trial. I never talked to the doctor who supposedly found the sponge, and I never saw any documentation that I was in fact her surgeon. That patient, a Ms. Lori Ufondu, did not come to Dr. Adams as she had claimed; she consulted another surgeon, Dr. Nicholas Chugay, who in fact was named as the lead surgeon in her case.  I happened to be in this doctor’s facility at the time she presented. He asked me to see this patient because she had had surgery previously, and he wanted to get another opinion. I examined her and suggested that he place her implants under the muscle because she was thin, and complaining that she could see wrinkling. Generally, “wrinkling” is the result of not enough soft tissue (subcutaneous fat) to camouflage or cover the implant, or that an implant is under filled. In this instance I felt that there was not enough tissue to adequately camouflage the implant. Placing it below the muscle, though not perfect, would allow him to camouflage it better. It would also minimize the problem with erosion of the implant through the skin over time. He asked that I be present when the surgery occurred.

Ms. Ufondu apparently had the procedure done and I can’t comment on whether I was present as an assistant or the primary surgeon. She presented her case more than seven years later. She did not win her case because she, or her lawyer, demonstrated that one of the doctors was at fault: she won her case because the surgery center had misplaced her chart and was unable to find it. For some reason they believed I had it, but I didn’t.

As a result, I reviewed over 200 augmentation mammoplasties that I had done personally. I have used lap pads in all of them and never, not once, a sponge.

 A lap pad is a large cloth used for soaking up blood. It measures about nine inches square and has a long blue ribbon attached at one of the four corners. It is a thick cotton material and frankly a lot of health care professionals use those left over from an operation (they come five to a pack) as dust cloths and rags for cleaning around their homes. A sponge, or 4×4, is a thin cotton mesh used as a dressing after surgery is completed. I use lap pads because that’s exactly what I was taught.

The person who taught me breast surgery was Ed Wilkins at the University of Michigan. Ed is a tremendous surgeon who is incredibly meticulous. He never allowed a sponge in the operating room during this procedure because when they’re wet, they’re like tissue paper, and frankly, easy to lose once they are wet. This is a practice that has followed me throughout my career. Since I have never used a sponge in these types of cases, the likelihood after reviewing 200 cases that I did in this only one, are unlikely. Nonetheless, I believe that surgeons should take responsibility for the care of patients and sometimes that means even when it is not specifically your fault, and I do that.

 I would, however, add that California law requires the presence of a registered nurse in the operating room. One of the duties of the registered (circulating) nurse is to keep an accurate count of sponges. I doubt seriously if any surgeon closed an open wound in a patient where a nurse advised that the sponge count was incorrect. Nonetheless, as I said before, it is the surgeon’s ultimate responsibility and for that I am more than happy to take the responsibility, but not the blame, for Ms. Ufondu. However, I do stand on my position and I will not alter that. I have never used, or allowed, a sponge like the one apparently found in Ms. Ufondu on the surgical field, in my twenty-year career, period.

Finally, Harvey moved on to attacking the issue of board certification, but Harvey didn’t really understand its significance, or what it meant:

 The American Board of Plastic Surgery certifies that the PLASTIC SURGERY PROGRAMS across the country meet certain minimum required standards by testing those individuals who have completed a certain minimum of requirements to sit for their exams.(What they are really examining is the program, not specifically the individual. This was also suggested to Amy Keith, a writer for People Magazine, by Dr. David A. Kulber, director of the Plastic Surgery Center at Cedar Sinai in Los Angeles. His quote: “{noncertification} suggests a problem in your training or education”. She ignored that. She made no effort to examine neither my education or training-and neither did Harvey Levin, Esq.)

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