Doctor shares concerns over safety

BY RIDGELY OCHSNewsday Staff Writer
One of Stony Brook University Hospital's own high-ranking heart surgeons is going public with concerns for patient safety at the facility, following the deaths of two children there.The deaths, which have occurred within the last two months, "appear to raise serious concerns about the safety net for patient care at the hospital," said Dr. Irvin Krukenkamp, who is associate dean for cardiothoracic academic affairs and professor of surgery, physiology and biophysics.Krukenkamp received a $3.3-million settlement in September after he claimed the university retaliated when he voiced similar worries about the death of another child. A hospital spokeswoman declined this week to discuss the lawsuit, but in the settlement document university officials denied any "wrongful conduct or liability or violation of any federal, state or local statute ordinance or law ... whatsoever."The critique from Krukenkamp comes as the state Department of Health investigates the June 26 death of 7-year-old Tyler Poole of West Islip and the May 13 death of 1-year-old Amee Martin of Mastic.Krukenkamp's current concerns about the use of proper procedures to avoid medical mistakes were echoed in his lawsuit, which he filed against the university and the hospital in February 2004. At that time, Krukencamp was chief of cardiothoracic surgery and director of the hospital's Heart Center.The suit charged that hospital officials decided to "terminate" him because he raised red flags about the care of an infant - identified only as Baby Doe - who died of heart illness in September 2003, after surgery in the pediatric cardiac surgery program. Krukenkamp's lawsuit was not the first time that questions had been raised about the program. In 1999, the state health department began monitoring it after three of 38 babies who had surgery that year died. As recently as February, health department spokesman Robert Kenny said last week, the state cited the program for violations "related to their quality assurance program and ... cases in which complications arose for patients post-surgically.""If the hospital fails to take all appropriate steps to correct the violations, we will consider closure of the program," he added.The hospital defended the program, saying it "has achieved extremely successful outcomes over the past several years." "We received the Department of Health's report addressing areas of concern and have responded. They have accepted our plan to address the issues they raised, and should return in September for an official review," the hospital said in a recent statement. In September, Krukenkamp, 49, who came to Stony Brook from Harvard in 1997, received a $3,375,000 settlement from the university plus promotion to associate dean and the right to stay at the hospital until 2007 and continue his research for another year after that.Nevertheless, he said he is worried about speaking out."I am truly fearful of making any further public statements at this time," said Krukenkamp. "My ability to speak out on such matters of public concern has been clearly chilled by my experiences at the hospital during the last two years." In the lawsuit, Krukenkamp, who was head of the committee that oversees quality assurance for cardiothoracic surgery, said that he raised concerns about the care of Baby Doe. The infant had been operated on by a pediatric heart surgeon from New York-Presbyterian Hospital who has been traveling once a week to Stony Brook since April 2001. Baby Doe developed complications after the first surgery, needed a second surgery and died shortly thereafter, according to the suit.In a letter dated Sept. 19, 2003, to Bruce Schroffel, then chief executive of the hospital, Krukenkamp questioned whether there was adequate surgical backup. He noted that the pediatric heart surgeon was at the university only once a week and there were no other doctors at the hospital with adequate experience in the highly specialized field. He also questioned what he termed in the lawsuit "the inherent conflict of interest" of having the hospital's medical director, Dr. Thomas Biancaniello, also chief of pediatric cardiology, involved in a review of the Baby Doe case.Soon after Krukenkamp raised questions, he said in the suit, he found he was not told about cardiothoracic surgery meetings or meetings were scheduled when he was operating. In November, he was told he was no longer supervising the pediatric congenital heart program, according to the suit. He also learned, he said, that the hospital had gone to an executive search firm to look for candidates to replace him. In addition, he said in the suit, the hospital's review process for Baby Doe "was being shut down."In early January, Krukenkamp met with university president Shirley Strum Kenny to voice his concern, he said in the suit. On Jan. 30, he met with Schroffel and Dr. Norman Edelman, who was then dean of the medical school and vice president of the Health Sciences Center. At the meeting, Krukenkamp said in the lawsuit, he was told that he should submit his resignation as chief of cardiothoracic surgery. Edelman told him that it was in "his best interest not to fight this," according to the suit.

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