FOX19 Investigates: When residents are allowed to operate - wave3.com-Louisville News, Weather & Sports

FOX19 Investigates: When residents are allowed to operate

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Patient Donna Miller noted she wanted “no medical students” doing her surgery. But residents are not medical students. And the hospital says it has no record of another document in which Miller says she indicated she wanted no residents either. Patient Donna Miller noted she wanted “no medical students” doing her surgery. But residents are not medical students. And the hospital says it has no record of another document in which Miller says she indicated she wanted no residents either.
CINCINNATI, OH (FOX19) -

Two Cincinnati women tell FOX19 they were stunned to learn young doctors, referred to as residents, had operated on them in surgeries that resulted in painful complications. However, teaching hospital leaders say residents aren't allowed to operate until they've undergone years of training and that it's safe.

But Donna Miller feels misled. When she met a veteran surgeon who was going to do her gallbladder surgery in Cincinnati, she says she asked him if he was the one who was going to be operating on her.

"And he said yes," Miller recalled. "Which to me, meant he was going to be doing my surgery."

However, the verb "do" seems to be in some dispute.

After a review of what happened in the operating room, University of Cincinnati Medical Center's Dr. Robert Wones, who's in charge of quality assurance, wrote Miller a letter, which she turned over to FOX19. In it, Dr. Wones said, "From our perspective, the resident surgeon did not ‘do your surgery,' (the veteran surgeon) did."

The surgery went from a one-hour operation to take out Miller's gallbladder to a five-and-a-half hour ordeal, according to Miller, after a liver specialist had to be called in after a resident accidentally cut open her common bile duct, which is near the gallbladder. Miller isn't happy with the hospital's explanation either.

"Every other word was, ‘We carefully did this, we carefully did that.' Carefully, carefully, carefully," Miller said. "Well, if they'd been so careful in the first place, I wouldn't have had to have had all that other surgery."

But from U.C. Medical Center's perspective, according to the letter written by Dr. Wones, the bile duct complication is fairly common. In fact, hospital spokeswoman Diana Lara says the common bile duct something a veteran surgeon might accidentally nick, too. However, it's not a "mistake," according to Dr. Wones' letter.

"We are sorry that this complication occurred but do not believe that it occurred because of a mistake or error on the surgeons' part," he wrote to Miller. "This complication was recognized promptly and treated appropriately by the team."

He also noted that it was a possible complication mentioned in the surgery consent form Miller signed, though it, too, is in dispute. There's a consent form in which a physician's assistant wrote "no medical students" next to a paragraph about residents and other personnel potentially being involved in the surgery. Miller put her initials under that. But she says she also signed another document, which the hospital says it has no record of, in which the physician's assistant crossed out the entire paragraph about residents and "other trainees" and Miller initialed.

From Miller's point of view, she clearly told the veteran surgeon she only wanted him operating on her and believes he gave her that assurance in their face-to-face consultation.

Dr. Wones, who agreed to sit down with FOX19 this afternoon but due to federal privacy laws could not discuss the specifics of Miller's case, says doctors should verbally inform patients about who's going to perform the surgery.

"I think I could agree with the statement that full and complete disclosure and transparency's a good thing," said Dr. Wones.

He says, though, that at a teaching hospital like UCMC the public should expect that residents will be involved in their healthcare. He believes that it's the hospital's affiliation with the University of Cincinnati that attracts some of the best surgeons in the country, many of whom want to be on the frontlines of medical research and teach the next generation of physicians.

By the time a resident is allowed to participate in a surgery, Dr. Wones says, they have undergone years of medical training.

"Our residents do (operate on) simulation mannequins, animals and so forth, before they operate on human beings. But yes at some point you've got to operate --- or examine or interview or whatever it is the doctors do --- on a real live patient," Wones said. "Otherwise, you would have no doctors."

Miller says that's fine. But she believes her wishes to not have anyone but the veteran surgeon operate on her were ignored. Complicating matters for her, she has no health insurance, inhibiting her access to good healthcare, she says. Miller wishes residents would only operate on those with health insurance in case there are complications. (The UCMC spokeswoman, through FOX19, welcomed her to get treatment for the pain she continues to endure since the hospital treats the poor and those without insurance. However, Miller told us she's too frightened to go back to UCMC and will never voluntarily go under the knife again anywhere.)

No one was sued in Miller's case. And no one was found to have committed malpractice.

Cincinnati medical malpractice attorney Don Moore, who hosts a weekly call-in show on FOX19, believes it's misleading for UCMC --- and teaching hospitals in general --- to claim that a veteran surgeon actually "did" an operation, when they merely supervised it.

"I don't think people think that way when it comes to driving a car or doing anything else that takes a great deal of skill," Moore said. "So the idea of saying that they're just doing the surgery, when they're letting a beginner learn without the patient's knowledge, is just wrong."

He also argues that the consent forms spelling-out the possibility of residents and other trainees performing the operation aren't sufficient because patients often aren't given enough time to read them before being asked to sign them.

However, patients at U.C. Medical Center are allowed to take consent forms home and study them, spokeswoman Diana Lara said. The forms only need to be turned-in by the time the surgery is set to begin.

Moore represented a woman who underwent a hysterectomy at an undisclosed Tri-State hospital and ended-up with a blood infection, resulting in sepsis. He allowed us to meet his former client as long as we agreed not to identify her because she signed a confidentiality agreement with the hospital as part of the lawsuit settlement.

Like Miller, Moore's former client blames the resident in her surgery for hurting her.

"She couldn't really tell what she was doing and she poked a hole in my bladder," the woman said.

She recalls that what was supposed to be a two-hour surgery turned into seven. She spent four days in the intensive care unit.

"I knew that residents could possibly watch and learn," she said, "but I didn't realize that they would be touching me."

The medical community says it is perfectly safe to be operated on by a resident. Studies on hysterectomies and gallbladder removals performed by residents showed no significant difference in the outcome than if they'd been performed by veteran surgeons, according to the summaries provided on the website of the National Institutes of Health.

The Ohio Medical Board points out that residents must obtain a training certificate before they can work in an Ohio hospital.

A spokeswoman there said Monday that of the 14 residents the board disciplined last year, all of the cases involved drug abuse, not malpractice.