HYANNIS — Cardiologist Richard Zelman, who says he was fired by Cape Cod Hospital after he wrote a letter expressing concerns about patients’ safety and loose credential requirements, has now had his hospital privileges suspended.
Zelman filed suit against the hospital, parent company Cape Cod Healthcare (CCHC), and CEO Michael Lauf on Dec. 6, seeking damages for lost wages and benefits, physical harm, and emotional distress. Zelman said he had been employed by CCHC for 30 years. He was medical director of the hospital’s Heart and Vascular Unit for the last four years.
At the time of his suspension, there were “three patients that I had done complex, critical procedures on that were still in the intensive care unit,” Zelman told the Independent. Another procedure that he was supposed to conduct on the morning of Dec. 22 was canceled because of the suspension, he said.
Zelman circulated his initial letter on Sept. 20 and expressed particular concern about left atrial appendage closures via the installation of a quarter-sized Watchman device, he said. The procedure prevents strokes in patients with atrial fibrillation by preventing clots from entering the bloodstream. It is an elective procedure that entails “significant risk,” Zelman said, “if it’s not done by somebody who has done high volumes and is expert in it.”
Zelman said he objected to the hospital giving credentials to doctors who should not have received them.
Zelman said that the standard recommendation is that “if you haven’t done more than 12 procedures in the last two years that you not be credentialed.” He said it has taken him hundreds of these procedures to feel comfortable conducting the operation, and that the physicians at the hospital who will now be operating without him on staff “haven’t done any procedures in three years.”
On Sept. 29 the hospital offered to renew Zelman’s contract at $1 million per year on the condition that he issue a statement expressing unequivocal support for all of the hospital’s cardiac services, including the one he had specifically expressed concern about, Zelman told the Independent.
Zelman said he refused to write such a letter, and his contract was not renewed. But he continued to see his private-practice patients at the hospital.
At about 5 p.m. on Dec. 21, Zelman told the Independent, he received a call from CCHC trustee Molly Sullivan notifying him that his hospital privileges had been provisionally suspended. Chief Operating Officer Lori Jewett was also on the line, Zelman said.
The suspension means that Zelman is prohibited from entering Cape Cod Hospital in any capacity other than as a patient, he said.
Zelman said he hopes to continue caring for his patients at his office in Hyannis and at St. Elizabeth’s Medical Center in Boston and Beth Israel Deaconess Hospital in Plymouth, where he retains privileges. He said he is applying for privileges at Beth Israel Medical Center in Boston.
Cape Cod Healthcare issued a statement on Tuesday about Zelman’s suspension, saying that the action “was taken independently by the hospital’s medical staff and neither Mr. Lauf nor the hospital had any role in the process, deliberations or final decision.”
The statement continued, “While Dr. Zelman will likely characterize this latest development as further retaliation against him, the facts will show that it has been Dr. Zelman’s own actions that gave rise to the decisions which he seeks to legally challenge.”
Dr. Nate Rudman, chief of emergency medicine at Cape Cod Hospital, confirmed on Tuesday that the medical staff had met and voted to suspend Zelman. Rudman also issued a letter defending Lauf, referring to him as an “outstanding leader,” and maintaining that “there has never been a single instance where any one of us has been asked to do anything other than to act in our patients’ best interest.” The letter was signed by 25 other physicians — all but two of the doctors in the hospital’s emergency department.
According to Zelman, the suspension of his hospital privileges was the result of a “sham peer review.” Those on the review committee, he said, were afraid of losing their jobs, and the review in this case was used to silence his concerns about “excessive surgical mortality.”
Zelman said that the death of a “low-risk patient” occurred in October and that he believes it could have been prevented had his concerns been taken seriously.
Dr. Lawrence McAuliffe, a CCHC cardiologist and former colleague of Zelman’s, told the Independent that he was “very supportive of Zelman, his skills, his vision, energy, his patient care. I think it’s a terrible loss.”
Zelman said there are hospital bylaws that “stipulate that they cannot provisionally suspend privileges unless the physician is an immediate threat to patients or other individuals.” He maintained that the hospital administration believed his Sept. 20 letter posed “economic harm to physicians.”
“They say I’m disruptive because I speak out,” Zelman said. “Well, I’m the same person I’ve been for 30 years.”
Zelman said that other doctors have been fired by Cape Cod Hospital, have been involved in lawsuits, and have accepted hefty settlements. “I’ve been the one person so far that’s not been willing to accept a million-dollar contract to buy my silence,” he said.
Zelman said he spent last weekend working in Florida to “maintain an income to afford lawyers and protection.”