Doctor says hospital fired him in retaliation

An emergency physician who was dismissed from a Pittsburgh hospital has filed a whistle-blower lawsuit accusing the facility's officials of turning a blind eye to concerns he had about patient safety and unsanitary conditions while he was employed there.

David M. Lemonick, MD, who resides in Pittsburgh, filed a complaint last month against Western Pennsylvania Hospital and West Penn Allegheny Health System, its parent organization. He claims his dismissal was retaliation for his good-faith reports made to hospital officials and therefore is prohibited under state whistle-blower provisions.

While the lawsuit does not cite a specific amount for damages, Dr. Lemonick is seeking restitution for lost wages and other benefits, as well as compensation for other damages, including emotional distress.

"The reason I believe I was fired was I was causing trouble for management by insisting upon patient safety," Dr. Lemonick said. "Rather than fairly addressing my well-intended suggested improvements, they chose to address my concerns by firing me."

Tom Chakurda, a spokesman for West Penn Allegheny Health System, said Dr. Lemonick's concerns were "promptly and thoroughly reviewed" by both hospital officials and an external physician review panel, which "clearly determined patient safety wasn't at risk." Chakurda said Dr. Lemonick was fired for disruptive behavior.

"This was not a matter of quality of care," Chakurda said. "This was a matter of Dr. Lemonick's inability to work professionally with colleagues."

Lawsuit claims concerns detailed early

Dr. Lemonick, who left the University of Pittsburgh Medical Center and started working at Western Pennsylvania Hospital in 2000, raised concerns early in his tenure about patient safety to the chair of the emergency department and the nurse manager, with little response, according to the lawsuit.

The lawsuit details several instances starting in 2003, which Dr. Lemonick says he brought to hospital administrators' attention. In one instance, a medical student allegedly didn't read for nearly an hour the test results of a patient who was having a heart attack, according to the lawsuit. The complaint also describes situations in which critical time would pass between when Dr. Lemonick would order a test or lab work and when it would be completed.

Dr. Lemonick said he started by bringing his concerns to the nurse manager and chair of the emergency department but later went to the hospital's patient safety officer and even the president. Dr. Lemonick said he was reprimanded on numerous occasions for his behavior, according to the lawsuit.

Dr. Lemonick was fired Nov. 24, 2004. He currently works in the emergency department at Highlands Hospital in Connellsville, Pa., about 50 miles outside of Pittsburgh.

"He's happy in his new job, but he has to drive 50 miles to get there," said Stephen M. Pincus, Dr. Lemonick's Pittsburgh-based attorney. "When you get fired these days, you don't just lose your position there. You lose it with the whole health system."

Chakurda said the health system planned to defend itself vigorously against Dr. Lemonick's allegations.

"Disruptive" theme gaining publicity

Bill Monnig, MD, an Ohio urologist and the AMA's Organized Medical Staff Section chair, is not familiar with Dr. Lemonick's case. But, he said, the idea of a disruptive physician recently has gained wide publicity. While there are physicians who need to be disciplined, hospitals are using a more liberal definition of the term to deny privileges to a doctor who, for example, may have invested in a competing surgical facility, he said.

Also, physicians and hospitals already could be at odds when patient safety issues come to the floor. A physician could be looking for a reason to complain, and even though the concerns might have merit, the hospital is quick to write them off because of the source, Dr. Monnig said. Then, "they label him as disruptive and get rid of him," he said.

"The safety complaints can be legitimate, but the process of dealing with the complaints is tainted by a history of relations," he said. If everybody's working together, which is what we want, these problems don't arise. We're never going to fix the problem ... in the light of public scrutiny."