Oregon State Hospital doctor who quit is back at job

From the Salem Statesman Journal, September 28, 2010

Deal saves lawsuit costs; mental-health advocates critical

A doctor at the Oregon State Hospital who claimed he was forced to resign after an investigation into a patient death returned to work Monday at the Salem psychiatric facility.

Dr. Michael Robinson has resumed patient care duties under terms of a negotiated settlement agreement between himself and the hospital.

Hospital Superintendent Greg Roberts said Monday in an e-mail to the hospital advisory board that the settlement agreement “gives us the certainty that a costly legal battle would be avoided.”

But mental health advocates criticized the hospital for cutting the deal with Robinson.

“As an attorney, I understand why disputes are compromised, but this one carries the lingering odor of an institutional culture that puts patient care down the list after the needs of other interest groups,” said Bob Joondeph, executive director of Disability Rights Oregon.

Joondeph criticized the settlement in an e-mail he sent to three top officials in the state Department of Human Services — Bruce Goldberg, human services director; Richard Harris, director of the Addictions and Mental Health Division; and Roberts, who took the reins of OSH on Sept. 20.

“This settlement does not line up with the OSH culture we are hoping to build,” Joondeph wrote.

The settlement agreement, dated Sept. 24 and obtained by the Statesman Journal on Monday, dictates that Robinson’s reinstatement to the psychiatric hospital will be short lived.

It says that he will “tender an irrevocable resignation” by Jan. 15, or earlier should he take another job prior to that date.

Other terms of the deal specify that Robinson won’t seek reemployment at OSH and that the hospital will provide him with a “neutral reference” consisting of positions held, job duties and salary.

The agreement also says that the hospital union representing Robinson will withdraw all pending grievances filed on his behalf.

Robinson, who formerly worked in the hospital’s forensic psychiatric program, now is assigned to the hospital’s geriatric treatment program.

Earlier this year, Robinson became the subject of a hospital investigation for his treatment of a forensic patient who died last year.

Moises Perez, 42, was found dead in his hospital bed Oct. 17. Witnesses said his death was not noticed by anyone for several hours. An autopsy showed that Perez died of heart disease.

An investigation by the State Office of Investigations and Training concluded that the hospital neglected Perez by failing to provide him with adequate medical care. Investigators reported that Perez’s caregivers on hospital Ward 50F failed to properly treat his chronic medical conditions and failed to develop a proper treatment plan for him.

Former hospital superintendent Roy Orr was forced to resign April 2 — the same day the state released the critical report examining lapses in Perez’s care.

Five hospital employees subsequently received letters of reprimand for their shortcomings involving Perez.

Robinson, the Ward 50F psychiatrist in charge of Perez’s care, was relieved of direct patient care duties in April pending results of a separate hospital inquiry into his treatment of Perez.

Amid the internal inquiry, Robinson informed the hospital that he would resign, effective July 31.

Robinson subsequently attempted to withdraw his resignation but it was rejected by hospital officials, who ordered him to turn in his identification and pick up his final paycheck at the end of July.

In seeking to withdraw his resignation, Robinson asserted in a July 9 letter to the hospital’s chief medical officer that his “resignation offer was made while I was under great duress from threats of adverse employment actions.”

The letter also said that it was Robinson’s understanding that “if I resigned, the hospital would cease their baseless and misguided efforts to damage my reputation as a medical professional.”

The settlement agreement between Robinson and the hospital came after months of negotiation.

Settlement terms are “binding on the parties,” the document says.

The hospital’s employment deal with Robinson comes as another OSH doctor is the subject of an internal investigation into his reported neglect of a patient.

Dr. Alexander Horwitz failed to examine a mental patient whose “excessive bleeding” later required surgery and a blood transfusion, according to a report by the state Office of Investigations and Training.

Investigators determined that Horwitz neglected the female patient’s care during his duty as on-call OSH physician on the night of May 26.

Horwitz reportedly failed to examine the patient, even though nurses notified him about the patient’s profuse bleeding.

Investigators concluded that hospital nurses may have saved the patient’s life by arranging for her ambulance transport to Salem Hospital.

Horwitz told investigators that no one told him there “was a need for faster action.”

Horwitz, who has worked at the state hospital since 1995, has been removed from on-call duties and is under “strict supervision,” Roberts said last week.

The hospital’s human resources department is conducting a separate investigation into the case. Additional actions may be taken against Horwitz, pending the outcome of the inquiry, officials said.