A top pathologist at Johns Hopkins Hospital has been placed on leave after an alleged misdiagnosis led to the removal of a patient’s bladder — as well as allegations he bullied staff, according to a report.
Dr. Jonathan Epstein, 66, is accused of pressuring other doctors at a world-renowned Baltimore hospital to give a second opinion that matched the diagnosis made by his wife, Dr. Hillary Epstein, a fellow pathologist, reports the Washington Post.
The news outlet cited a hospital accreditation report by the nonprofit Joint Commission and four people with knowledge of the situation who spoke on condition of anonymity.
Epstein, the hospital’s director of surgical pathology, gave a second opinion that agreed with the opinion made by his wife, who works at Chesapeake Urology Associates in Beltsville, Maryland, according to the newspaper.
In one instance, a patient had his bladder removed – only to have a post-operative analysis show a different diagnosis, according to the Washington Post, which cited sources and accreditation reports.
The Joint Commission ordered Johns Hopkins to address concerns among staff “about a culture of bullying and intimidation in the surgical pathology department,” which it said exposes patients to inappropriate care.
Epstein was placed on administrative leave in May, according to the newspaper.
Pathologist Dr. Jonathan Epstein has reportedly been placed on leave by Johns Hopkins Hospital in Baltimore due to misdiagnosis and claims of bullying from staff. Courtesy
The commission’s report — released in August — did not address Epstein’s involvement in second opinions about his wife’s work, but sources told the Washington Post that it played a role in the alleged “intimidation” or “bullying.”
Epstein wrote in the paper that he was “deeply distressed” by the allegations, “because they are the antithesis of everything I have stood for and tried to demonstrate in my 35 years of professional life at Johns Hopkins.”
He declined to address bladder removal cases because of patient privacy considerations but said, in general, medical cases “have a lot of complicating factors.”
Epstein also denied that there was any conflict of interest by providing a second opinion on the report made by his wife, saying he considers such cases “solely based on my objective assessment of the case.”
The nonprofit organization The Joint Commission ordered Johns Hopkins to address concerns “about a culture of bullying and intimidation in the surgical pathology department.” AP
“As a specialist in prostate and bladder pathology, I review cases where there is disagreement between [Hopkins] pathologists who do not have specific training in prostate and bladder pathology and [Chesapeake] a pathologist (who specializes in the field),” he told the outlet in a written statement.
Hillary Epstein did not respond to a request for comment by the Washington Post.
Severa Lynch, a spokeswoman for Chesapeake Urology, declined to comment on the bladder removal case, also citing patient privacy, but said the practice is committed to the highest standards of care.
The representative added that Chesapeake never exerted influence over the hospital’s review of its pathology reports.
“These cases are being forwarded for the sole purpose of obtaining an independent review,” Lynch told the newspaper in an email. “This practice has been integral to our mission to provide high-quality care to our patients, as it ensures the fair interpretation of diagnostic slides.”
Epstein allegedly pressured doctors to provide a second opinion to match the diagnosis made by his wife, Dr. Hillary Epstein.
A Hopkins spokesman defended the hospital’s pathology department.
“The Johns Hopkins Department of Pathology is nationally renowned, and we remain confident in the best-in-class service they provide,” Liz Vandendriessche told the outlet in an email, adding that the hospital is working closely with the Joint Commission to address the issue. cited in the report.
“In fact, some of their quotes have already been removed as a result of the information we provided,” he added.
A spokesman for the Joint Commission did not respond to the paper’s request for comment.
Although it did not refer to Epstein by name, the Joint Commission report said several complaints had been made by other doctors against the “head of the department,” according to the Washington Post.
The investigators received “multiple comments by pathologists and residents who expressed their discomfort in speaking out about ‘intimidating’ or ‘bullying’ behavior by the head of the department, indicating that they had to change the diagnosis, issue an addendum and delay the wishes of the leader. several years, thus potentially bringing harm to the patient.”
Doctors said “they fear retaliation or career repercussions if they speak up,” according to the report, which did not provide specific details about the behavior it described as bullying.
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Epstein claimed that when he worked with other pathologists, they would show him difficult cases.
“It has always been my impression that these discussions are collegial, professional and conducted in the interest of patient care,” he told the newspaper.
“I only ask for cases to be amended when they are specifically sent to me for my opinion by patients, doctors and pathologists, and were initially diagnosed by others in my absence. After my review, in a minority of cases I amend them so that the patient, based on my expertise , getting the most accurate diagnosis that leads to optimal therapy,” he added.
In response to allegations that he pressured other pathologists to change reports, Epstein said those with expertise in other areas, such as breast pathology, would sometimes show him difficult prostate or bladder cases.
Epstein confirmed that he has been on paid administrative leave “pending an evaluation of my response to the allegations,” but said he was not interviewed by the Joint Commission or given an opportunity to comment on its report.
“I always adhere to my professional responsibilities, and treat all staff, students, interns, patients, faculty and health care professionals with respect, civility, and fairness,” Epstein wrote in the paper. “When in a supervisory role, I have tried to resolve differences and counsel colleagues and subordinates constructively and personally.”
Epstein, who joined Johns Hopkins in 1985, has written several papers on the detection of cancer and other diseases.
In 2003, he was the pathologist who issued a report on Sen. John F. Kerry (D-Mass.), who is running for the Democratic presidential nomination, according to the outlet.
He said microscopic examination of tissue near Kerry’s prostate showed that the cancer there had not spread.
Johns Hopkins has been ranked in the top five best hospitals in the US for the past 33 years, according to US News & World Report.
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Source: thtrangdai.edu.vn/en/
