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Nurses Tell Neurosurgeon to Wait for Sterile Instruments
The Drunken Bully Explodes
Arrested Outside Operating Room
The Drunken Bully Explodes
Arrested Outside Operating Room
First, the news account ...
Highland (Hospital, Oakland, CA) Surgeon Suspended
Drunken Altercation Reported in Hospital's Operating Room
By Jim Herron Zamora
San Francisco Chronicle
Thursday, March 9, 2006
OAKLAND -- The top neurosurgeon at Highland Hospital has been suspended and may be charged with a misdemeanor after what authorities called a drunken altercation with sheriff's deputies in an operating room, officials said today.
Deputies believe Dr. Federico Castro-Moure, 45, was intoxicated during the scuffle and prosecutors may charge him with public drunkenness and interfering with a peace officer.
"The deputies felt that he was behaving in an aggressive manner," Alameda County Sheriff's Capt. William Eskridge said. "He was yelling and put a fist in the face of a deputy in a threatening manner."
Neither Castro-Moure nor his attorney could be reached for comment.
The incident began about 8:30 p.m. Monday when Castro-Moure argued with nurses recommending that he wait several hours for sterile equipment to arrive before operating on a spinal patient.
Although Castro-Moure wanted to operate immediately, other hospital personnel believed the surgery could be delayed because the patient was stable enough to wait, said Dr. David Altman, the hospital's chief medical officer.
In such cases, it is the hospital's policy to wait. But Castro-Moure became angry and physically and verbally abusive, officials said. A nurse summoned deputies to the foyer outside the fifth-floor operating room.
When deputies attempted to intervene, Castro-Moure allegedly shouted obscenities and used his arm and clenched fist to keep them at bay, officials said.
Although the deputies arrested Castro-Moure on suspicion of public intoxication -- based upon both his behavior and the smell of alcohol on his breath -- Eskridge said the doctor was so uncooperative that deputies could not adequately test him for intoxication.
"He compromised the test by not blowing the amount of time the test needs to get an accurate reading, but the device did indicate there was some alcohol in his system," Eskridge said.
The unidentified patient was in the emergency room at the time and remained there throughout the incident, officials said. His spinal operation occurred Tuesday morning, and he is recovering satisfactorily, Altman said.
Altman announced Thursday that Castro-Moure has been suspended without pay. Castro-Moure, Highland's head of neurosurgery since 2003, will be barred indefinitely from practicing at the hospital pending several investigations by the hospital and county health officials, Altman said.
The California Medical Board, which holds licensing power over all doctors in the state, is expected to launch its own investigation of Castro-Moure. The board could potentially strip him of the ability to practice medicine in the state.
"I cannot confirm or deny that we have an investigation because that is not a public record," said Erlinda Suarez, analyst California Medical Board. "But I can tell you that in any case like this with wide media coverage we would probably initiate an investigation based on media reports," Suarez said.
Altman said Alameda County Medical Center officials are "very concerned." Although there is no specific policy banning alcohol consumption by doctors before surgery, Altman said doctors and other employees are barred from working when "impaired in any way by drugs or alcohol." He also said it is hospital policy to immediately report any person with alcohol on their breath.
"We will not tolerate unprofessional conduct that could endanger our patients," Altman sad. "That is unacceptable."
Castro-Moure has been at Highland Hospital since November 1999 and had no history of misconduct, Altman said. Castro-Moure received his medical degree from Collegio Mayor de Nuestra Senora del Rosario in Bogota, Colombia, and his doctorate from Wayne State University in Detroit.
"He is a well-respected neurosurgeon, well respected in his field," Altman said.
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Emphases by WBI
Commentary by Dr. G. Namie ...
This outburst in the OR by a surgeon is not uncommon. We know from consulting to hospitals who want to curb bullying that extreme misconduct against nurses is standard M.O. for many surgeons who rule their "kingdoms." And for once, the nurses got to see the bully temporarily brought down.
This type of conduct is what I read as an expert witness in court cases involving bullying physicians. Similar things happened in the trial dubbed the "first bullying trial" in Indianapolis, IN in March, 2005 in which I testified.
How rare were angry, hostile, bullying rants by Castro-Moure? Was this the first and only time that an otherwise respectful, gentle man exploded? Not likely. The statement by the chief medical officer about Castro-Moure's normalcy means little. He probably never works directly with him in the OR, the workplace that bully surgeons terrorize. He only sees him through an administrative lens and as a fellow physician, a club member deserving protection.
The aftermath will be worth tracking. Will the Medical Board do anything since they rarely strip licenses? Will the chief of staff, Altman, have the guts to sanction Castro-Moure or will that be seen as capitulation to nurses? Will Highland Hospital, the county government employer, implement a policy to prevent this from happening again? [We do work with motivated hospitals but eventually they balk at applying anti-bullying policies to the docs.] Will the nurses union demand action to make them safe? Will the patient's family sue for the involuntary delay?
Bullying in hospitals jeopardizes patient care and staff safety. But most administrators are too timid to confront and constrain thugs like Castro-Moure. This unfortunate incident gives the public and bully sympathizers a rare peek behind the hospital door to show what nonsense is tolerated on a daily basis by nurses.