August 2, 2001 - Physician Draws 18 Malpractice Lawsuits, But No State Action
In the past 20 years Dr. Wartanian, an obstetrician who practices at Harbor Hospital in Baltimore, has been sued for malpractice by at least 18 women. While some suits proved without merit, nine resulted in payments totaling well over $2 million. An ob-gyn doctor can expect to be sued 2.53 times during his or her career - a number that Wartanian has exceeded several times over. Yet the 55-year-old obstetrician-gynecologist has never faced state disciplinary action, and his license to practice medicine been never been restricted.
According to testimony Wartanian has given in court cases, he attended a medical school in Armenia in the mid-1960's and graduated first in his class. He worked at a hospital in Beirut, Lebanon, before coming to the United States in 1974.
According to the available records, Wartanian is near the top of the state's 10,127 practicing physicians in eliciting such suits. The chairman of the American College of Obstetricians and Gynecologists' professional liability committee says a pattern of lawsuits such as the one compiled by Wartanian is extraordinary.
The head of Harbor Hospital's ob-gyn department, Dr. Samuel Smith, said its credentialing committee conducts "a tight review" of each doctor, as he or she comes up for a renewal of privileges, that includes going over malpractice claims for the previous two years. "If we identify a physician that is having problems for whatever reason," Smith said, "there is corrective action," such as counseling or remedial education. In granting privileges, the hospital is saying physicians are "meeting professional standards."
All states wrestle with the problem of what is the best way to monitor physicians. State regulators often have to deal with issues of substance abuse, sexual misconduct and criminal behavior, but their hardest task is determining whether doctors fail to meet accepted standards in treating patients.
For example, some states provide far more information to the public about the track record of physicians than does Maryland, where residents can find out little beyond whether a doctor has ever been disciplined by the state's regulatory board.
In interviews at his office next to Harbor Hospital and over the phone, Wartanian, who lives in Lutherville, said the malpractice suits filed against him have all been unfounded. He said he considers himself to be a good doctor. "I'm proud of my practice, and my patients are my best judges, not the lawyers," he said. "I can give you hundreds of names of (satisfied) patients. I know I've given my best to my patients. Ninety-nine percent of my patients are happy with me."
Dorothy E. Bennett, a nurse who has worked with Wartanian for 25 years, has high praise for his skills. "I think that he is probably the best doctor I work with," she said. "He's the kind of person that, if you ask him for help, he'll help you all he can." She attributes the large number of malpractice cases against Wartanian to the fact that he maintains a very busy practice and is "not always very tactful" in dealing with patients, adding: "He tells people the truth, and they don't always like that."
But some former patients who have sued Wartanian questioned how the doctor could maintain a license in good standing after so many alleged medical mistakes. "I just can't imagine he doesn't have to answer to someone," said Smith, the Dundalk woman who lost her child. "They should have done something by now, obviously."
Baltimore attorney Daniel M. Clements, who filed Hayes' lawsuit, also wonders why Wartanian has never drawn a disciplinary action. Clements wrote letters to the state regulatory board in 1994 and last year formally calling for an investigation of Wartanian's professional competence. "Never before in my career have I been moved to file a complaint with the board ... about a physician's care," Clements wrote in 1994. "However, never before have I been confronted with a physician whose history and actions so unequivocally call for a review."
In a recent interview, Clements said: "It's not uncommon to find a doctor who has been sued two or three times, but this guy wasn't close. People make mistakes, but at some point the sheer volume of cases has to be evidence of incompetence."
Despite the legal trouble, Wartanian appears to have a thriving practice. According to the American Medical Information Physician Directory, he sees 90 to 100 patients a week and works with a number of HMOs and health plans. Despite the large number of malpractice suits against him, his professional record remains untarnished by any disciplinary actions. In a sworn statement last fall in connection with a recently settled suit, Wartanian said his privileges to practice medicine had never been revoked, curtailed or suspended at any hospital.
Maryland's doctors largely regulate themselves. Physicians decide whether to review a colleague's skills and whether the results warrant disciplinary action. In addition, the state board responsible for licensing and disciplining doctors, the Maryland Board of Physician Quality Assurance, often ignores a provision in state law that requires doctors who have three or more malpractice claims filed against them within a five-year period be reported to the regulatory board.
While some Maryland doctors with long histories of malpractice complaints have eventually lost their licenses, others, like Wartanian, have never been disciplined. And it can take more lawsuits and time before state regulators take some action.
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