The board of trustees of Catholic Medical Center has hired a Pittsburgh law firm to investigate how the hospital oversees patient care after a Boston Globe Spotlight Team series revealed that a former heart surgeon had accumulated one of the country’s worst surgical malpractice settlement records, while the hospital allegedly did little to address warnings from employees.
Facing criticism from patient families, their own medical staff, and state legislators in the wake of the stories about Dr. Yvon Baribeau, CMC’s trustees announced on Thursday that Horty, Springer & Mattern would conduct an “independent, external review.”
“This review will help us understand what could have been done better in the past, but most importantly, it helps us chart a future based on industry-leading best practices,” said Tim Riley, chairman of CMC’s board of trustees of the hospital in Manchester, N.H.
The results of the review could have repercussions for the current executive leadership, some of whom have been accused of concealing problems involving Baribeau, a once-celebrated cardiothoracic surgeon who amassed 21 medical malpractice settlements.
CMC’s chief executive Alex Walker, who held leadership roles when much of the complaints about Baribeau surfaced, has defended the hospital’s handling of the heart surgeon and denied that the administration kept important information about Baribeau’s work history from the public.
In a statement on Thursday, Walker said he welcomed the review.
“I’m grateful to the Board for initiating this review to reassure our employees and patients,” Walker said.
Walker told CMC staff in a separate e-mail obtained by the Globe that Horty Springer would have access to any resources it needed and encouraged the staff to be open and honest in speaking to reviewers.
Representative Mark Pearson, the chairman of a state legislative committee that has appointed a panel to investigate the controversy at CMC and how the state medical board oversees physicians, said he met with Walker for more than an hour on Thursday afternoon and was assured that the review would be independent.
Walker “will not be part of that investigative process,” Pearson said.
The law firm will investigate the quality and safety of CMC’s cardiac surgery program, the peer review and credentialing process, and how the hospital’s leadership handled physicians’ concerns. Horty Springer will not examine the specific medical procedures done by Baribeau. Instead it will look at how cases, including Baribeau’s, were reviewed, according to Pamela Diamantis, a CMC board vice chair.
CMC would not guarantee that the report would be made public.
Baribeau was one of the hospital’s busiest and best-paid surgeons until he retired in 2019 after a run of deadly outcomes and years of complaints. The Globe series disclosed that Baribeau settled 21 malpractice claims tied to his work at CMC, including 14 in which he was alleged to have contributed to a patient’s death.
Baribeau, in a previous statement relayed by his lawyer, told the Globe that he agreed to settle a group of 17 claims made against him in 2020, covering surgeries over six years, “to avoid lengthy and protracted litigation in my retirement.” He said the settlements included no admission of wrongdoing.
Several doctors faced retaliation from the administration after they expressed concerns about Baribeau, according to colleagues, an allegation the hospital has denied.
Horty Springer is a familiar name in health care consulting.
The firm works with hospitals and health care systems to draft governance bylaws, advises institutions on the peer review process and medical staff investigations, and holds national training seminars for medical leaders.
The firm also represents hospitals in legal disputes with regulators over kickback and false claims allegations and in employment disputes with physicians.
More than a decade ago, CMC had hired Horty Springer to do some document review for the hospital, Diamantis said.
CMC’s current relationship with Horty Springer will be under the auspices of “attorney-client” privilege, according to Diamantis. Such relationships can raise questions about how independent and transparent the ultimate findings will be.
Some lawyers hired to conduct such investigations specify in their engagement letters that such privilege is waived, in an effort to boost the independence of the probe.
CMC said it was appointing a special four-member committee of the board to handle the external review. The committee will be led by Diamantis, a Manchester wealth manager and vice chair of the board, and also includes two recently appointed hospital trustees. Tom Donovan, who oversaw the state’s charitable organizations for the New Hampshire attorney general’s office, will serve on the committee as an independent member.
Horty Springer can “ask the questions they need to ask, review the documents they feel they need to see, and speak with whomever they feel they need to speak with, without prejudice or guardrails,” Diamantis said in a statement.
Diamantis said she anticipates that after the review is complete — a process expected to take several months — the board will discuss the findings with the state, its hospital employees, and the community. But she did not say whether it would be made public.
Ellen J. Zucker, a Boston lawyer who represented two physicians in lawsuits against Massachusetts General Hospital after they criticized surgeons who oversaw more than one operation at a time, said it was critical that CMC makes public all of Horty’s findings.
In 2011, MGH hired a former US attorney, Donald Stern, to investigate complaints to hospital officials about concurrent surgeries, also known as double-booking. The hospital kept Stern’s report secret for years, but the hospital’s president at the time, told the Globe in 2015 that Stern “found no basis to support” the concerns of complaining physicians.
Zucker, who represented the complaining doctors, repeatedly requested the Stern report. But MGH lawyers insisted it contained legal advice from Stern to the hospital and was protected by attorney-client privilege.
The state and federal courts ultimately ordered the Stern report unsealed after concluding that MGH hired Stern to conduct an internal review, not to provide legal advice. The report painted a more complicated picture than hospital administrators had previously described.
“When you hear of an investigation into something that has gone terribly wrong, as a patient, you want to know that you’re going to hear the results,” said Zucker.
During an employee-wide meeting last month, Walker acknowledged that the case has shaken public confidence in the Manchester hospital. The Catholic hospital runs one of the biggest heart centers in New England north of Boston.
The Globe series also revealed that New Hampshire’s medical board is one of the least transparent in the country. Baribeau’s physician profile on the New Hampshire medical board website suggests a pristine record, while his profile on the Massachusetts medical board website — where he was also licensed — lists 20 of his 21 medical malpractice settlements.
In response to the Globe stories, state legislators are also holding hearings on whether the New Hampshire board of medicine’s policies and practices must change to provide patients more information about physician discipline and malpractice settlements.
The state’s attorney general has also launched a “review of the practices of the New Hampshire Board of Medicine, along with the rules and statutes that govern their activities,” which will be made public when it is completed.
Lindsey B. Courtney, the executive director of the New Hampshire Office of Professional Licensure and Certification, which oversees the medical board, declined to comment when asked whether the board itself is reviewing how it handled Baribeau’s case. Dr. Emily Baker, head of the state’s medical board, did not respond to the Globe’s request for comment.
“With multiple State reviews now ongoing it would not be appropriate for OPLC or the New Hampshire Board of Medicine to offer any further comment,” Courtney said in an e-mailed statement.
Deirdre Fernandes can be reached at email@example.com. Follow her on Twitter @fernandesglobe. Jonathan Saltzman can be reached at firstname.lastname@example.org.