2108 Acorn Court
Lebanon, Pa. 17042-5769
May 21, 2001
HONORABLE TOM RIDGE
GOVERNOR COMMONWEALTH of PENNSYLVANIA
225 MAIN CAPITOL BUILDING
HARRISBURG, PA. 17121
Ref: Commonwealth of Pennsylvania, Bureau of Professional and Occupational affairs vs. Robert Lester Barton; File No. 99-49-01928
Dear Governor Ridge:
My letter to you today is in regard to the case I have referenced, but has much broader scope than just this case. It involves what I believe to be an intentional effort by elements within the PA. Department of State, to deny due process through inaction and deception. In order to explain this thoroughly, I must begin with a brief synopsis of my referenced complaint with the BPOA.
My mother had a heart attack and died March 1, 1997. According to her medical records, she complained of symptoms of coronary artery disease (CAD), a dangerous life-threatening condition, on February 23, 1996, more than a year prior to her death. Her physician was aware of her symptoms as well as her diabetes and family history of heart disease. His use of the terms "ASHD" which is an abbreviation for arteriosclerotic heart disease, and "angina" confirm it. On 2/23/96 he prescribed nitroglycerine to treat the angina, a symptom of CAD, but he did not initiate a referral for her for tests to determine the severity of the disease, not then or ever. My mother's conditioned worsened over the course of the following year, a period in which she saw her physician eight more times. On January 7, 1997, with my mother complaining of being short of breath, Dr. Barton once again prescribed nitroglycerine to treat her angina. Finally, with rising blood pressure and concerns she was going to have a heart attack, my mother went to see Dr. Barton, on February 5, 1997, the date of my father's scheduled appointment, under a sense of urgency, concerned she might soon have a heart attack. She left that day finally with an appointment to the Lebanon Cardiology Center for tests scheduled for February 11, 1997. Unfortunately, the tests Dr. Barton prescribed, a non-stress echocardiogram and a Holtor monitor EKG, are inappropriate for detecting CAD. The tests were negative, and my mother died three weeks later.
After my mother's death I contacted several legal firms with the intent of filing medical negligence/malpractice charges against Dr. Barton in civil court. I was unable to find a firm willing to take the case because my mother was 75 and unemployed. The potential judgement was not large enough to interest any of them. Since these firms bear the costs of bringing cases to trial, deriving their earnings contingent on winning the case, they obviously try to insure that the case is both winnable and sufficiently rewarding to cover both costs and return on the investment. My mother's case did not qualify. I could have tried to pursue legal action by hiring an attorney on a fee basis, but the costs of bring a medical case to court are very high. I considered it anyway when I found out about the Pa. State Bureau of Professional and Occupational Affairs Hearings for Medical Practitioners. I phoned their Complaints office and was told they do indeed take disciplinary actions against doctors in medical negligence and malpractice cases. In addition, I learned there was no time limit on pursuing such action. That appealed to me, as other obligations were pressing at the time. In the end I decided on the Pa. State BPOA hearing process. I have since learned to regret that decision.
After considerable research and preparation, I submitted my formal complaint against Dr. Barton on April 5, 1999. On my initiative, I followed the process of investigation through pre-legal review throughout 1999. By December 1999 the case had been forwarded to the Pa Dept. of State Legal Office where it has been ever since. In effect the investigator and the legal aid reviewing the case apparently deemed it worthy of due process, or it would not have been forwarded to the DOS Legal Office. The attorney who has been assigned my case will not respond to any inquiries from me. The only responses I have received have come after prodding from Senator Brightbill's office on one occasion, and after a letter written by attorney on another. On both occasions the prosecuting attorney claimed he was unable to obtain an "expert" to review the case. I accepted that argument on March 31, 2000, but not on April 4, 2001.
The prosecuting attorney is alleged to be looking for a cardiologist to review my case. Dr. Barton diagnosed coronary artery disease, but over the course of a year, did not initiate any action to help my mother outside of prescribing nitroglycerine to treat her symptoms of CAD. Any honest practitioner can tell you this is medical negligence. It is by far the most serious charge according to the DOS prosecuting attorney. Pennsylvania law requires expert testimony to establish the applicable standard of care in medical malpractice cases. I have recently discovered an exception to that rule applies "where the matter is so simple and the lack of skill or want of care so obvious, as to be within the comprehension of non-professional persons." The medical negligence aspects of my case fit that description perfectly. The act of incompetence in referring my mother for improper cardiology tests is another matter, but insignificant compared to the charge of medical negligence. My complaint was well prepared. I spent months researching and referencing all the medical aspects of the case. My references reflect opinion by cardiologists for which I found no contradiction. They primarily substantiate the charge of incompetence in referring my mother for improper cardiology tests. My references can easily by checked out at the Hershey Medical Library. The prosecuting attorney's insistence on a cardiologist is simply an attempt to justify delay. My realization of this has come over time.
Beginning in the late spring of 1999, I have attempted to attend a BPOA medical malpractice/negligence hearing in order to gain an understanding of the process. I did this so I could adequately prepare for Dr. Barton's hearing, which I planned to attend and possibly testify. After attending a case that originated out-of-state, I began to pre-screen scheduled cases searching for one relevant to the case I had submitted. After previewing about 30 cases over a period of 6 months, I was unable to find a single medical malpractice/negligence case. I began to suspect that cases like mine are never brought to a hearing. At one point in my search, an employee of the Office of the Prothonotary, where such hearings are held, inadvertently admitted as much to me.
Pa. State Board of Medicine I have learned it is the Pa. State Board of Medicine that is the ultimate force in deciding cases against medical doctors, although they delegate the hearing process to the Office of the Prothonotary and the DOS Legal Office. I have also learned from a Pa State Board of Medicine report on disciplinary actions against medical doctors over a 14-month period, only 2 doctors were disciplined in this state on charges of medical malpractice/negligence from January 28, 1997 through March 24, 1998. About 67% of cases originated out-of-state or were administered for failure to pay into the Cat Fund. The case involving malpractice was a voluntary surrender of license to resolve "allegations" of malpractice." The negligence case was a disciplinary action for "practicing medicine with negligence on repeated occasions." The Pa. State Board of Osteopathic Medicine has an equally shameful record in regard to doctor discipline. I was not surprised to discover the majority both boards are made up of doctors. They are reluctant to testify against each other in medical malpractice cases and they apparently will not discipline other doctors when in control of the Pa. State Boards of Medicine.
In addition to the elements of medical negligence and incompetence in the case I submitted to the BPOA, there are irregularities in my mother's records indicating the records may have been altered on a later date. There appear to be changes to the records specifically on the two charts where nitroglycerine was prescribed. One change refers to a stress thallium test that never took place and the second appears to be a referral for a Persantine thallium stress test that also never took place. It appears to me that alterations may have been made in an attempt to cover up the fact that nitroglycerine was prescribed without any consideration to the danger my mother was in at the time. Altering records is in violation of the Commonwealth of Pennsylvania, Pennsylvania Code, Title 49. Professional & Vocational Standards Department of State, State Board of Medicine. The charges of Medical Negligence and potential alteration of records can be brought against Dr. Barton without need for a doctor, let alone a cardiologist, to review the case. The problem, of course, is both charges require enforcement. It does little good to have rules if they are not enforced. The Pa. State Boards of Medicine are obligated under Pennsylvania law to protect the public health and safety. My experience and the Board statistics suggest the Boards are more concerned with protecting doctors than the public health and safety. Since you appoint members of both Boards and are ultimately responsible for the performances of these two organizations, I hope the information I have provided will be of interest to you. I would appreciate hearing from you in this regard. Perhaps it would be best if I could discuss this matter with you or one of your staff in person.
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