New Hampshire’s professional licensing agency has launched a broad investigation into whether former executives at Catholic Medical Center in Manchester endangered public safety by failing to report problems with a troubled heart surgeon, according to people with knowledge of the matter.
This unusual step by the state’s Office of Professional Licensure and Certification follows revelations in a Boston Globe Spotlight Team series last September that Dr. Yvon Baribeau amassed one of the nation’s worst surgical malpractice records: 21 malpractice settlements connected to his work at Catholic Medical Center, including 14 cases in which he was accused of contributing to patients’ deaths. The Globe reported that hospital executives knew for years how dangerous Baribeau had become, but allowed him to continue to practice.
“It’s a broad investigation to determine who knew what, when, and where, and what was done or not done,” said one of the sources, who asked for anonymity because they are not authorized to discuss the confidential probe.
The investigation by the OPLC, which oversees the running of the New Hampshire Board of Medicine, is focusing on two doctors who were top administrators at Catholic Medical Center, the sources told the Globe, examining whether they failed to report disciplinary actions or restrictions in privileges involving Baribeau to the medical board. The investigation will include subpoenas to gather information and medical records, they said, and it could ultimately encompass other hospital leaders.
Throughout Baribeau’s quarter-century tenure at Catholic Medical Center, the surgeon appeared to have a pristine record on the medical board’s website, despite a 28-day suspension of privileges by Catholic Medical Center for inappropriate patient care. Amid staff outcry over deaths and injuries related to his surgeries, Baribeau abruptly retired in 2019.
This state probe comes in addition to a separate internal review launched by the board of Catholic Medical Center in the wake of the Globe report.
When asked about the state investigation, Jessica Kallipolites, OPLC’s director of enforcement, said, “As investigations are confidential, I am unfortunately unable to confirm whether there is such an investigation currently underway.” Medical board president Dr. Emily Baker also said she could not comment.
Catholic Medical Center spokeswoman Lauren Collins-Cline said Wednesday that the hospital was not aware of any new state probe, but would cooperate with the agency if contacted.
The hospital, meanwhile, is facing significant financial and leadership difficulties.
The 330-bed facility’s bond rating has tumbled in recent years, and in October, Moody’s Investors Service revised the hospital’s outlook from stable to negative, signaling that Moody’s believes its current rating of Baa3 could fall into “junk bond” status.
“That is the kind of milestone you don’t want to pass,’’ said David Williams, a health care consultant in Boston and president of the Health Business Group, because it would make it more expensive for the hospital to borrow money.
According to Moody’s, the vast majority of US nonprofit hospitals and health systems are in a stronger financial position than Catholic Medical Center. The hospital had about $161 million of debt outstanding as of fiscal year 2021, Moody’s noted, and was expected to incur an operating loss in fiscal year 2022.
Catholic Medical Center has also seen a wave of management departures in recent months. Several executives have left or announced their departures since September, including the hospital’s chief financial officer, chief operating officer, and chief medical officer. The executive medical director of the flagship heart institute where Baribeau worked, who had publicly defended the surgeon, announced his planned retirement in September.
The hospital is led by Alex Walker, a longtime Catholic Medical Center executive who took over the CEO role from Dr. Joseph Pepe in 2021.
In December, GraniteOne Health — a regional health care network of Catholic Medical Center and two other hospitals — announced it was dissolving. Earlier plans for a merger between GraniteOne Health and Dartmouth Health were abandoned last May after New Hampshire Attorney General John Formella objected to the deal.
Spokeswoman Collins-Cline said Catholic Medical Center, like other hospitals, had experienced financial and operational difficulties over the past three years. She said the financial challenges were “primarily driven by high labor costs, patient flow issues and a lack of beds, and staff and supply costs,” and the hospital was taking steps to address them. She said leadership departures “were due to planned retirements, desires to make career changes, and turnover that you would see at a large institution like CMC.”
Catholic Medical Center’s management has also come under intense scrutiny since the Globe’s report, which found that over the years, hospital leaders were repeatedly warned by medical staff that Baribeau’s errors were harming and even killing patients, yet executives resisted reining in the high-volume heart surgeon, who was a powerful revenue driver. More than 40 current and former staff spoke to the Globe for its report, many of them fearing retaliation for their statements.
Speaking to the Globe last year, Walker, the hospital’s CEO, defended Catholic Medical Center’s handling of Baribeau and praised the hospital’s quality-review process. “We have built a culture of safety and compliance and quality in this organization for a very, very long time,” Walker said.
Following the Globe’s series, Catholic Medical Center’s board of trustees hired an outside law firm last October to investigate how the hospital oversees patient care. For months, the Pittsburgh law firm, Horty, Springer & Mattern, has examined issues including the credentialing and peer review processes and how leadership handled physicians’ concerns. The firm’s lawyers told the Globe this week that it has also engaged NorthGauge Healthcare Advisors to evaluate the hospital’s cardiac surgery program.
Meanwhile, for the state probe, OPLC investigators have already exercised subpoena power to interview Catholic Medical Center doctors who wrote a letter to the licensing agency in October, raising serious concerns about the hospital’s leadership.
“We believe the CMC administration is interfering with and undermining the safe practice of medicine,” three doctors wrote in their letter, a copy of which was obtained by the Globe.
“[I]n regards to the practice of Dr. Baribeau, the administration interfered with and undermined the clinical oversight and accountability, peer review, and reporting process in violation of the law and to the detriment of the consuming public,” the doctors wrote. “It is because the administration failed to address the concerns of competent and conscientious providers that Dr. Baribeau was allowed to practice for as long as he did under the circumstances.”
In their letter to the OPLC, the doctors also said they believed the hospital administration had violated a law that requires it to report within 15 days any “sentinel event.” According to the Joint Commission, which accredits hospitals, a sentinel event is a safety-related event that results in a patient’s death, permanent harm, or severe temporary harm.
“We believe there was an effort on the part of administration to ‘bury’ these cases,” the doctors wrote.
The OPLC, which received authorization from the medical board for the current probe, sought to initiate a second investigation into additional matters involving Baribeau, but faced resistance from the medical board, people with knowledge of the matter told the Globe.
Two bills pending in the state legislature, including proposed reforms from Governor Chris Sununu, would give the licensing agency more authority to launch such investigations for numerous licensing boards. Among other things, the legislation would empower the OPLC to probe allegations of physicians’ misconduct on its own initiative, without needing advance authorization from the medical board.
Attorney General Formella has also completed a review of the medical board’s practices, initiated at Sununu’s request, and the findings will be made public, a spokesperson for Sununu said.
Jonathan Saltzman, Liz Kowalczyk, and Deirdre Fernandes of the Globe staff contributed to this report.