Prominent UA doctor taunted as 'Robo Rob' says settlement clears him

2014-05-25T00:00:00Z 2014-05-28T16:16:03Z Prominent UA doctor taunted as 'Robo Rob' says settlement clears himBy Stephanie Innes Arizona Daily Star Arizona Daily Star

A prominent Tucson cardiac surgeon who was prohibited from seeing patients earlier this year says he has cleared his name in a settlement with the hospital that suspended him.

Dr. Robert S. Poston, 46, said Thursday that a hearing scheduled to begin last week was canceled when he signed a sealed agreement with the University of Arizona Medical Center, resolving a legal action he’d filed against the hospital after his suspension. He says he’ll leave Tucson and is considering job offers on the East Coast.

“I am pleased to report that the matter has been amicably resolved, I have been cleared of all allegations and no payment of funds was involved,” Poston said.

UA Medical Center officials would only say that a settlement with Poston was reached and that no funds were involved.

“Under terms of the settlement, we cannot comment further,” spokeswoman Katie Riley wrote in an email.

Two cases triggered suspension

Poston was suspended with pay Jan. 28 after a clinical peer review. While state law protects what’s discussed during peer review as private and immune from lawsuits, a transcript from a prior hearing about Poston’s legal case was provided to the Star.

At a Feb. 24 hearing in Maricopa County Superior Court, Poston’s lawyer Calvin Raup said the suspension was triggered by two cases in which patients were prepped for surgery and put under general anesthesia, but the surgeries were not performed. In both cases, a transesophogeal echocardiogram (TEE) performed after the patient was put under anesthesia showed surgery wasn’t warranted, Raup is quoted as saying in the transcript.

Raup said in court that suspending Poston over those cases was unreasonable. New information is sometimes discovered in the TEE, a test used to determine heart function that is not typically used before surgery, he said.

The peer review committee at the UA Medical Center subsequently cited more of Poston’s surgeries as part of its action against him. His summary suspension deemed him an imminent threat to patient safety, court transcripts say.

Robotic surgery
an issue

Poston’s legal action blamed his suspension on bias in the peer review process. He said his specialty in minimally invasive robotic cardiac surgery at the UA Medical Center made him an outlier from the get-go, frowned upon by more conservative surgeons who distrusted a newer technique.

Many doctors don’t like robotic surgery, arguing it is all bells and whistles with little benefit to patients. Some colleagues began referring to Poston as “Robo Rob.”

Since minimally invasive surgeries have a shorter recovery time than typical heart surgeries in which the sternum is split, Poston contended he was seen as taking money away from the cardiologists who typically care for cardiac inpatients.

The UA Medical Center is no longer performing the minimally invasive robotic cardiac bypass surgeries that were Poston’s specialty.

“The big negative result of all this is that we lose one of the top heart surgeons in the U.S. To attract someone of his caliber again is going to be difficult,” said Scott Brittenham, a Tucson business executive and member of the National Board of Advisors at the UA’s Eller College of Management.

Brittenham, who spent 17 years on the University of Nebraska’s Board of Trustees, had contacted the Arizona Board of Regents asking that it consider appointing a special counsel to investigate Poston’s suspension.

Poston performed Brittenham’s minimally invasive aortic valve replacement surgery in 2012.

Hospital gossip blamed

Though Poston would not talk specifics of his case after the settlement, he told the Star earlier this week that months before he was suspended, a gossip-fueled campaign was already eroding his reputation.

He said peer review confidentiality was repeatedly breached by colleagues who were spreading rumors that he’d had bad patient outcomes long before his suspension, even though his records show his mortality and complication rates were better than average. He cited a June 29 gathering of surgery residents — Poston was not in attendance — with a cake that was altered to say, “Goodbye Rob.”

Patients and former colleagues from across the country had been scheduled to come to Tucson to testify on his behalf last week.

Poston, who spent $350,000 trying to clear his name, said he’s had clinical privileges at 12 different hospitals and before the UA Medical Center was never subject to a performance-related peer review.

Gene Corbett, a recruiter with St. Louis-based Physician Finders is working with Poston on finding a new position. He says there is interest from other hospitals who were waiting for him to resolve his case. Poston is one of about 10 surgeons in the country who have done more than 100 robotic mitral valve surgeries per year, and his skills are in demand, Corbett said.

“For the university to summarily dismiss all charges and then void the suspension that they put forth on him means they had no case and no way to prosecute it, which means this was all a waste of time and a waste of money,” Corbett said.

Peer review
and patient safety

Clinical peer review, supported by the American Medical Association and The Joint Commission hospital accrediting body, was created for the best of reasons — patient safety. It’s a forum where medical peers can police physician competence and ensure doctors are performing at a high enough standard to hold clinical privileges.

Most states have decided that doctors and a hospital’s medical staff should police their own colleagues rather than having another entity like the government do the job. Arizona’s first peer-review law was passed in the 1970s and has been amended several times since then.

It’s common for doctors to argue that a negative peer review was the result of politics, said Karen C. Owens, a Phoenix-based attorney who has represented both physicians and hospitals in peer-review cases, and currently represents UA Medical Center.

Yet the process is often criticized by patients for not being punitive enough, she said, stressing that her comments do not relate to the Poston case, but to peer review in general.

“The disadvantaged party is the hospital because the hospital cannot tell you anything about any peer review that may or may not be going on,” Owens said. “It is prohibited. ... And so we’re stuck.”

Contact reporter Stephanie Innes at sinnes@azstarnet.com or 573-4134.

Copyright 2014 Arizona Daily Star. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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