An Open Letter of Apology to Melissa Rivers

Joan Rivers

Dear Melissa,

I owe you an apology on behalf of my irresponsible medical colleagues who let their shallow ego cloud their clinical judgment and ultimate killed your mother.

I took the death of your mother personally because we were both born in Brooklyn and that connection alone creates a bond that transcends cultural, economic and social differences. Joan Rivers was a Brooklyn girl and on that solitary principal, she was loved and revered.

Dr. Gwen Korovin, the specialist who performed the fatal procedure did not have privileges to operate in the t clinic, yet jumped ahead of the staff and began to operate which caused a cascade of mistakes. She had to stop the procedure at least once because she couldn’t see as reported by the staff during the State investigation. The wrong amount of anesthesia was given. A biopsy was done without her permission

The New York State investigation of your mom’s medical fiasco only brings to light what happens on a daily basis. As I type this letter, medical negligence is occurring. Somewhere an office, clinic or hospital is understaffed and therefore not equipped to handle an unforeseen emergency; or someone did not check the equipment because they were distracted; or, an important lab report was missed because of lack of follow-up or; someone is not following medical protocol or standard of care.

Melissa , you have every right to be angry. Physicians like Korovin make all of us look bad although most of us don’t have medical practices on prime New York City real estate or celebrity patients.

As a physician who has been committed to patient safety for years longer than I care to admit, let’s take this tragedy and turn it into a victory. Let’s establish a Joan Rivers Patient Safety Awareness Act that will educate the public on red flags to be aware of before they have medical procedures. If we do this in honor of your mom, maybe she can finally rest in peace.


Joan Rivers’ Death Could Have Been Prevented and Kanye’s Mom as Well

Joan-Rivers-Condition-Remains-Serious-as-Melissa-Says-Thankskanye-donda-e1347650770445We all know that death is an inevitable part of life, but sometimes errors in human judgment makes it happen too soon .

I loved Joan Rivers because she was a straight shooter and originally from my hometown of Brooklyn, New York. People from Brooklyn don’t bite their tongues and I’m not going to bite mine now.

What the heck was her physician thinking when he agreed to do a major procedure in an office setting. To the uninitiated, having a tube stuck down your throat might sound like a “simple” procedure, but if it’s being done under general anesthesia, the rules of the game change.

General anesthesia means that you are being put in a medically induced coma and receiving drugs that affect your breathing, ability to move, feel pain and your nervous system. It is a procedure that involves close monitoring and medical clearance prior to being done, especially if you’re over age 50. A physical exam is necessary that includes an evaluation of your heart via an EKG. With the exception of excessive bleeding, the most common surgical complication occurs because of general anesthesia and not the procedure itself. Joan Rivers was an 81 year old woman, for goodness sake, despite her youthful appearance based on aesthetics. Why on earth would someone operate on an 81 year old woman in a setting that can’t handle emergencies? She should have clearly been in a hospital where a potential complication could be quickly addressed. Was there a crash cart at that outpatient clinic? Could they handle a “stat Code Blue?” Probably not which is why they had to call 911 and have Rivers transported to Mount Sinai Hospital several blocks away.

And poor Dr. Donda West, the mother of Kanye mom suffered a similar fate. She had multiple cosmetic procedures done in one setting, under general anesthesia and died.

Yes, New York State will conduct their investigation and probably find nothing wrong but those of us who are trained physicians know better. What killed Joan Rivers and Donda West? Poor clinical judgment and it really needs to stop.

“I Messed Up Bad”

Cheating is never good especially when it involves public and patient safety. Annie Dookhan messed up by her own admission and although she is free on $10,000 bail, neither the City of Boston nor the State of Massachusetts will ever forget her. As a result of her shameful actions as a public servant, the Massachusetts Public Health Commissioner resigned and 2 state employees of a state-operated crime lab were fired, ending their careers. How does one teach someone how to do the right thing, even when no one is looking? Is integrity an inborn human trait or does it have to be taught? These are the questions that come to mind as I ponder Dookhan’s fate.

Dookhan was a 34 year old chemist who worked for the State of Massachusetts for 9 years and tested more than 60,000 samples for drugs that involved 34,000 defendants and gave the wrong results.  She performed 500 tests a day which aroused the suspicion of her fellow colleagues who performed an average of 50 to 150 samples a day. She was also caught forging her co-workers signatures on forms as a means of eliminating an important step in the drug screening process. Although employees reported their suspicion to their supervisors, some were reluctant to take action and others reviewed her forms but never cross-checked her samples which is standard procedures.

Dookhan also testified under oath that she held a masters degree in chemistry from the University of Massachusetts but none could be found. She also admitted to the police that she deliberately turned negative urine samples into positives on more than one occasion.  The Massachusetts Attorney General is now involved in this case as well as the governor. The entire lab had to be shut down and is now under the jurisdiction of the Massachusetts State Police. Approximately 1141 inmates in state prisons and county jails have been affected and could possibly go free.

Dookhan alleges that she cheated because she felt pressured to “do more work.”  She has been accused by others of being ambitious to a fault. While she may have wanted job security and a good performance evaluation, she certainly went about it the wrong way.

“Cheaters never win and winners never cheat.”A breach in public trust is unforgiving. Yes, Annie, you did mess up. You messed up bad.