nose from the brain itself, and any surgeon operating there must have a steady and educated hand.
On August 3, 1994, Anthony operated on a deviated septum (the center cartilage in the nose) in a 30-year-old man. He clumsily entered the outer layer of the brain, a critical mishap that greatly increased the patient’s susceptibility for brain abscess, meningitis, and nerve damage. In this case, the patient’s brain fluid actually leaked into the nasal passages, but Anthony told no one and sent the patient home from day surgery.
A senior otolaryngologist who studied the case reported that there were serious questions, of both “omission” and “commission,” about Anthony’s surgical technique. The specialist questioned whether Anthony had the credentials to continue doing endoscopic sinus surgery.
The following day, Anthony’s hospital privileges were canceled. He was fortunate that the young man with the deviated septum didn’t develop deadly meningitis.
In 1992, Anthony had fortuitously added a second hospital that gave him temporary operating privileges, Our Lady of Victory Hospital. But in February 1993, Anthony operated on a seventy-one-year-old patient who agreed to elective surgery to remove a laryngeal tumor for biopsy. It was, in some aspects, a routine procedure, but any time a patient is operated on deep in the throat, his main route to get oxygen to the lungs can be compromised. Sensitive tissue can swell or hemorrhage.
Anthony’s patient died.
A hospital board reviewed the operation and immediately restricted his privileges. After that, he was not allowed to do elective procedures involving the airway after 1:00 P.M. , and before that hour, he had to be monitored. The chief of surgery and chief of otolaryngology met with Anthony to explain that it was extremely important not to disturb laryngeal tumors any more than necessary, and that he should have been prepared for swelling and excessive bleeding at the site of surgery.
Anthony was indignant that they should lecture him as if he were a mere intern.
Anthony’s privileges at Our Lady of Victory expired in September 1993, and the hospital did not renew them.
Anthony no longer had any hospital where he was welcome to operate or treat patients. He applied for privileges in otolaryngology and plastic surgery in Irving, New York, and at Buffalo Mercy Hospital. He wasn’t accepted because he had no proof to back up his statement that he was board-certified in those specialties.
Anthony suspected that one of the department chairmen at Thomas Jefferson Hospital in Philadelphia might be blocking him by failing to endorse him as a doctor of good moral character worthy of taking the board exams. He fought back by suing his last training hospital and the chairman.
Thomas Jefferson submitted the names of seven ear, nose, and throat specialists to serve as arbitrators. Any one of them was competent to evaluate Anthony’s level of skill in this speciality.
Characteristically, Anthony balked. He came back with his own list of three otolaryngologists. That was no problem for Thomas Jefferson Hospital; they agreed to let the matter be decided by the very first doctor on Anthony’s list.
Although Anthony was intelligent enough, he was ultimately self-defeating. In his rage at anyone who had the temerity to block him from doing what he wanted, he often failed to reason things out carefully. He apparently expected the past to disappear into a kind of mist where no one remembered details.
“Dr. H.,” the physician whom Anthony himself had chosen, set about gathering statements that were either for or against the subject. He interviewed specialists who had worked with Anthony Pignataro. Usually physicians tend to close ranks and protect each other. So many things can go wrong in diagnosis, treatment, and surgery that they are hesitant to point fingers at other doctors, knowing that they too could make mistakes. Not this time.
In the end, Dr. H.’s report
On August 3, 1994, Anthony operated on a deviated septum (the center cartilage in the nose) in a 30-year-old man. He clumsily entered the outer layer of the brain, a critical mishap that greatly increased the patient’s susceptibility for brain abscess, meningitis, and nerve damage. In this case, the patient’s brain fluid actually leaked into the nasal passages, but Anthony told no one and sent the patient home from day surgery.
A senior otolaryngologist who studied the case reported that there were serious questions, of both “omission” and “commission,” about Anthony’s surgical technique. The specialist questioned whether Anthony had the credentials to continue doing endoscopic sinus surgery.
The following day, Anthony’s hospital privileges were canceled. He was fortunate that the young man with the deviated septum didn’t develop deadly meningitis.
In 1992, Anthony had fortuitously added a second hospital that gave him temporary operating privileges, Our Lady of Victory Hospital. But in February 1993, Anthony operated on a seventy-one-year-old patient who agreed to elective surgery to remove a laryngeal tumor for biopsy. It was, in some aspects, a routine procedure, but any time a patient is operated on deep in the throat, his main route to get oxygen to the lungs can be compromised. Sensitive tissue can swell or hemorrhage.
Anthony’s patient died.
A hospital board reviewed the operation and immediately restricted his privileges. After that, he was not allowed to do elective procedures involving the airway after 1:00 P.M. , and before that hour, he had to be monitored. The chief of surgery and chief of otolaryngology met with Anthony to explain that it was extremely important not to disturb laryngeal tumors any more than necessary, and that he should have been prepared for swelling and excessive bleeding at the site of surgery.
Anthony was indignant that they should lecture him as if he were a mere intern.
Anthony’s privileges at Our Lady of Victory expired in September 1993, and the hospital did not renew them.
Anthony no longer had any hospital where he was welcome to operate or treat patients. He applied for privileges in otolaryngology and plastic surgery in Irving, New York, and at Buffalo Mercy Hospital. He wasn’t accepted because he had no proof to back up his statement that he was board-certified in those specialties.
Anthony suspected that one of the department chairmen at Thomas Jefferson Hospital in Philadelphia might be blocking him by failing to endorse him as a doctor of good moral character worthy of taking the board exams. He fought back by suing his last training hospital and the chairman.
Thomas Jefferson submitted the names of seven ear, nose, and throat specialists to serve as arbitrators. Any one of them was competent to evaluate Anthony’s level of skill in this speciality.
Characteristically, Anthony balked. He came back with his own list of three otolaryngologists. That was no problem for Thomas Jefferson Hospital; they agreed to let the matter be decided by the very first doctor on Anthony’s list.
Although Anthony was intelligent enough, he was ultimately self-defeating. In his rage at anyone who had the temerity to block him from doing what he wanted, he often failed to reason things out carefully. He apparently expected the past to disappear into a kind of mist where no one remembered details.
“Dr. H.,” the physician whom Anthony himself had chosen, set about gathering statements that were either for or against the subject. He interviewed specialists who had worked with Anthony Pignataro. Usually physicians tend to close ranks and protect each other. So many things can go wrong in diagnosis, treatment, and surgery that they are hesitant to point fingers at other doctors, knowing that they too could make mistakes. Not this time.
In the end, Dr. H.’s report
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