The tale of Dr. Yvon Baribeau is more than the sum of a record-shattering number of medical malpractice settlements, more than the personal pain and tragedy of the families who brought them and more than the crises of conscience felt by some of his colleagues.
No, at its heart it’s about a hospital and its governing board that did too little to stop the damage as the surgery gravy train kept rolling and a state medical board so derelict in its duty to protect patients that even today it remains complicit in shielding Baribeau’s sorry record.
Baribeau, a cardiac surgeon at Catholic Medical Center in Manchester, N.H., for nearly three decades amassed one of the worst surgical malpractice settlement records in the nation, according to a recent two-part series reported by the Globe’s Spotlight Team.
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The first of those malpractice cases was filed in connection with a 1994 lung surgery performed not even two years after Baribeau joined the hospital. It was settled in 1998 for about $1 million.
Many of the settlements that followed would contain confidentiality agreements forbidding the families from discussing their cases. That was the case for the family of Frank Pelligrino.
Pelligrino came into the CMC emergency room in September of 2014 with a behind the knee blood clot. Pelligrino’s leg was later amputated after Baribeau opted to do an elective surgery on another patient before tending to Pelligrino.
“The system is severely broken,” his daughters said in a statement. “People’s lives have been absolutely devastated by the lack of intervention in allowing these atrocities to occur and continue unchecked.”
The pattern of requiring such confidentiality agreements is a familiar one for those who remember the Spotlight series of two decades ago about the Catholic Church’s cover-up of the sexual abuse by priests of minors in their charge.
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“Since 1997, the archdiocese has settled about 50 lawsuits against [the Rev. John J.] Geoghan, for more than $10 million — but with no confidential documents ever made public,” the Spotlight report noted about just one of the accused priests.
The practice was wrong then, and it’s wrong now.
Hospital executives in an e-mail to CMC staff Wednesday promised to bring in an outside firm to do an independent review of hospital procedures in the wake of the Globe series. But in an online “town meeting” with employees CEO Alex Walker denied that the hospital withheld information about Baribeau’s work from the public — a fact that flies in the face of its use of nondisclosure agreements.
Greater transparency around those past settlements — and a pledge not to use them in the future — would certainly be evidence of Walker’s sincerity.
Even more critical would be transparency on the part of the New Hampshire Board of Medicine, which still lists the now retired Baribeau as having a flawless record. That’s contrary to the Massachusetts Board of Registration in Medicine, which lists medical malpractice claims filed against Baribeau dating back to 1999.
In fact, a 2019 study by Public Citizen, a consumer advocacy group, put New Hampshire’s medical board dead last among states for the rate at which it disciplines physicians and among the least transparent in the data it makes available to the public. (Massachusetts ranks around the middle of the pack on disciplinary issues.)
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The study also compared public data collected by the National Practitioner Data Bank (NPDB) and found that by the end of 2019, some 8,633 physicians had five or more malpractice payment reports since the NPDB starting collecting such information in 1990. “Yet, dangerously and unacceptably,” 76 percent of those physicians had “never had a medical board licensure action of any kind, serious or non-serious.”
State licensing boards, hospitals, and other health care entities are all required to report disciplinary actions and certain adverse events to the NPDB. Malpractice insurers and other payers are also required to report payments made on behalf of individual practitioners. That physician-specific data, however, is not available to the public but only to licensing authorities and hospitals.
The obvious answer to leveling the health care information playing field would be for Congress to amend the Health Care Quality Improvement Act that created the NPDB to allow anyone to check up on a physician’s record. That would, of course, raise the hackles of the American Medical Association, which as a matter of policy “opposes all efforts to open the National Practitioner Data Bank to public access” and “strongly opposes” public access to malpractice case payments.
Improving the operations of the New Hampshire medical board would be simpler and has the potential to bring more immediate relief. And there is one hopeful sign in that regard with the appointment earlier this year by Governor Chris Sununu of Dr. David Goldberg, a former Catholic Medical Center cardiologist, who filed a successful whistleblower suit against the hospital and Baribeau.
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“My priority as a doctor has always been to advocate for top medical care and patient safety,” Goldberg told the Spotlight team.
Sununu has at least two current vacancies to fill on the board, including one of its public members. That too can make a difference — assuming the governor has an abiding interest in putting patient safety first. The board should follow up on that independent investigation promised by the hospital — to assure that it is indeed independent, that its findings are shared with the public, and that any flaws are corrected.
The case of Yvon Baribeau may be an outlier, but it certainly won’t be the last of its kind. Health care consumers in New Hampshire at least deserve the right to make better informed decisions before literally putting their lives in a physician’s hands.
Editorials represent the views of the Boston Globe Editorial Board. Follow us on Twitter at @GlobeOpinion.
