Dec. 26, 2004, 5:47PM
A Houston orthopedic surgeon who has been sued for malpractice more than 60 times and accused by patients' relatives of causing four deaths and two suicides could have his medical license revoked and be fined a record $210,000 early next year.
The license revocation proposed by two administrative law judges who heard the case against Eric Scheffey could end one of the most notorious careers in Houston medicine. The Texas State Board of Medical Examiners is expected to act on the recommendation in February.
"If I had to paint a scenario of a doctor who was practicing medicine in the worst possible way I can imagine, it would be this scenario I see with Dr. Scheffey's practice," said Dr. Donald Patrick, who became executive director of the medical board three years ago.
Scheffey, 54, and his family lived in River Oaks and later in a $5.8 million home near the Museum of Fine Arts while he practiced in the lower-income areas of east Harris County. He was one of the busiest doctors at Vista Medical Center, a Pasadena hospital cited frequently by regulators for inadequate patient care. In 2002, Scheffey was the top-paid doctor in the Texas Workers' Compensation program, earning $3.3 million.
Between 1985 and 2003, at least four patients died under his care, according to lawsuits and patient records, and two other patients committed suicide while pursuing malpractice claims against him. Scheffey was the most-sued doctor in the nation, according to an analysis done in 2000 by the Hartford (Conn.) Courant of legal actions reported to the National Practitioners Data Bank. He failed his certification exams for orthopedic surgery three times.
The board has twice before considered revoking Scheffey's license, and he has spent nearly half of his career on board-ordered probation.
But this time around, the board has more resources for investigations, a tougher stand on medical malpractice issues and a strong executive director in Patrick, a neurosurgeon and lawyer.
In his responses to lawsuits and board inquiries, Scheffey has portrayed himself as a champion for needy and neglected patients, fighting insurance companies to provide essential treatment to injured truck drivers, hotel maids, fast-food workers and others in similar jobs.
"Dr. Scheffey's resistance to the insurance companies, including their Dr. No's, have made him a target. That target is to remove him from his capability to act on behalf of his patients," his longtime lawyer, Ace Pickens of Austin, wrote in his defense.
But in testimony before the two administrative law judges, expert witnesses said Scheffey had harmed rather than helped several recent patients, including some who had little education or were mentally ill, and one who was homeless.
In case after case, Scheffey's practices were unproductive or even harmful, according to the findings of Judges Shannon Kilgore and Michael Borkland, who heard the medical board's case against Scheffey over five days in Austin in May.
They found that Scheffey had contrived reasons to operate, repeated unnecessary procedures, falsely told patients that it was routine to remove rods and wires after spinal surgery, and often did more in the operating room than either the patient or other doctors had authorized.
He gave some clients too many pain pills, expert witnesses said. And he left a confusing, vague paper trail, omitting details in medical records, delaying reports, and recording the same symptoms and same physical exam findings for patient after patient — leading experts who reviewed those records to conclude Scheffey had simply made things up.
In reviewing records on a patient who had surgery on both wrists in August 2001, Dr. Michael Epstein, a Baylor College of Medicine surgeon, whom the board paid as an expert witness, said Scheffey could not have done the procedures in the 29 minutes he said he did. "It would have been impossible for a surgeon to accomplish all the listed procedures in such a short amount of time," Epstein said.
The judges based their opinions on information presented by medical board lawyers, testimony from six expert witnesses retained by the board and Scheffey's testimony. The expert witnesses were board-certified orthopedic surgeons who combed through Scheffey's patient records. Among them were Epstein, who specializes in hand and wrist surgery, and Dr. N.F. Tsourmas, who serves as medical director for the Texas Mutual Insurance Co., the largest workers' compensation insurer in Texas.
No expert witnesses testified for Scheffey because "physicians he talked to expressed fear of retribution (from the medical board) and would not come," Pickens said. The board suspended the license of Dr. Floyd Hardimon, who worked for Scheffey and participated in some of the surgeries examined at the hearing.
An attempt to reach Scheffey, whose office is closed and home number unlisted, through his lawyer was unsuccessful.
"E.B.," as he was identified, sustained severe injuries to his neck, upper back and lower back in 1998 when his truck was crushed by an overhead loader, or "cherry picker." He was treated initially with medication and chiropractic care, but when imaging studies showed some spine problems, Scheffey referred him to a pain specialist.
The specialist noted E.B. had a "difficult personality" marked by panic attacks. Another doctor said the patient had dementia and would have difficulty understanding the magnitude of the planned surgery. The specialist suggested that treatment be stopped and that E.B. receive a psychological evaluation.
Instead, E.B., who took 1,500 high-strength painkillers prescribed by Scheffey over 10 months, authorized Scheffey to perform a procedure to relieve pressure on a nerve in his back, as well as implant rods to help fuse vertebrae that were causing problems, according to board testimony.
Scheffey's report on the man's Oct. 24, 2000, surgery showed a much more extensive undertaking, performing procedures on parts of the spine that were not causing pain.
A surgeon reviewing the case for the medical board noted that no rehabilitation plan was documented and that such an operation would not "return a laborer to labor. Unless this patient is strongly counseled and assisted in obtaining vocational rehabilitation, then the patient will be permanently disabled by the operation."
During surgery, E.B. lost 2 liters of blood — roughly 40 percent of an average adult's total blood volume. The next day, his temperature exceeded 105 degrees. Scheffey ordered an ice pack. Over the next few days, the man's temperature kept spiking, his abdomen became hard and distended, and he passed blood in his stool.
He was not transferred to a different hospital, and a specialist wasn't called until the fifth day after the surgery. On the sixth day, he died. The autopsy found pneumonia and a blood clot in his lungs, and his entire large intestine had stopped working because of ischemic colitis, a condition in which the blood supply to the intestine is cut off.
"This large segment of dead bowel was a lethal complication," Dr. George Tipton, a spine surgeon in Austin, said in testimony given to the judges.
From 1976 to 1977, he did a yearlong surgical internship at the Medical University of South Carolina. He next did a four-year orthopedic residency in adult and children's orthopedics, spine surgery, hand surgery and joint replacement.
In 1981, he began practicing in east Harris County, starting out in Baytown, near shipyards and other industry. From the start, most of his practice involved workers' compensation patients, Scheffey told administrative law judges. He estimated he has done as many as 3,000 spine operations.
In 1988, he bought a 12-room house in River Oaks on West Lane that is now valued at $2.53 million, according to the latest Harris County appraisal records. Ten years later, he bought an 18-room, 10,055-square-foot house on Longfellow Lane in a gated neighborhood across the street from Rice University. He recently sold the house for more than $5 million.
Described by patients as charming and engaging, Scheffey was able to recruit patients into treatment plans that violated the standard of care in orthopedic surgery, according to the judges' report. His critics say Scheffey created strong bonds with his patients by going to bat for them against the Texas Workers' Compensation Commission, which rejects as many as a fourth of proposed spinal surgeries, according to testimony at the hearing.
During Memorial Day weekend in 1985, he was arrested when 30 grams of cocaine were found in his Jaguar, though he was not convicted in the case. Five days before that arrest, a patient, Mary Tywater, died on the operating table. In 1986, the board placed Scheffey on 10 years probation for "intemperate use" of drugs, even though he had admitted he'd been using cocaine for at least 18 months prior to the 1985 arrest. The probation order does not mention Tywater's death.
In the May hearing, Scheffey acknowledged that as of 1994, he and his insurers had paid more than $10 million to settle malpractice lawsuits. Unable to get malpractice insurance anywhere else, Scheffey obtained minimal coverage from companies unlicensed to provide it in Texas from 1994 to 2001, according to board documents.
By 1995, administrative law judges had proposed that Scheffey's license be revoked for performing unnecessary operations and overcharging for treatment. Instead, the medical board voted to give Scheffey probation until 2000.
Scheffey, who has repeatedly sued his critics, fought the order in court for three years, so his new probation did not take effect until 1997, when he lost an appeal to the Texas State Supreme Court. That meant his five-year probation lasted less than three years.
Houston truck driver Kevin Butler went to Scheffey in 1999 after he twisted his left knee and injured his ankle in a fall on the job. One doctor diagnosed Butler with a severe ankle sprain and saw nothing wrong with the knee on an MRI.
Scheffey performed six unnecessary surgeries on Butler over 10 months, administrative law judges found. Butler, now 41, can't work or stand for long periods and his knee is permanently damaged, said his lawyer, Priscilla Walters.
Scheffey "has the training — everything but the ethics, morality and judgment of a true physician," said Walters, who also is representing another Scheffey patient included in the medical board's case. "He became a surgery/billing machine."
Another patient, Cecil Viands, a cook at Popeye's, sought Scheffey's services after he slipped at work and fell, injuring his back. Scheffey operated on him in August 1992, March 1993, June 1993, November 2001, September 2002 and May 2003. Administrative law judges said many of the spinal fusions performed repeatedly failed, often at the same surgical site.
After his last surgery, Viands developed an infection. He died Aug. 29, 2003.
Three months later, the state medical board suspended Scheffey's license in an emergency action, describing him as "a continuing threat to the public welfare." The board also suspended Hardimon's license. Scheffey's practice, which once had employed as many as 26 people, was effectively closed.
The State Board of Medical Examiners, which in the past three years has increased its legal staff and stepped up enforcement, accepts some of the blame as well. On the 1995 complaint against Scheffey, medical board lawyer Robert Simpson said, "The board had a reputation for, and probably to a significant degree was guilty of, protecting doctors more than the public."
"They were always trying to get the right set of cases to put him away," board chief Patrick said. "Somehow, the combination of right cases, legal strength in the agency and appropriate disciplinary vigor didn't match up."
Two small for-profit hospitals, Doctors Hospital-Tidwell in north Houston and Vista Medical Center in Pasadena, gave Scheffey staff privileges despite his disciplinary record, although Doctors ended its relationship with him in 2001. Both hospitals are included in malpractice suits filed by Scheffey's patients.
In one of those suits, plaintiff's attorney Les Cochran says Scheffey's actions were "calculated to wring the maximum amount of workers' compensation insurance out of" his client's on-the-job injury.
The suit also alleged that Scheffey routinely treated patients negligently either because he was incompetent, had a "malicious disregard" for his patients "or because he has some personality disorder that prevents him from recognizing the difference between right and wrong."