discrimination, retaliation
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07/28/2008, 22:23:27
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RE: L. Wang Vs. Kingsbrook Jewish Medical Center,Brooklyn, NY 11203-1891

To Whom It May Concern,

I was a former medical resident in Kingsbrook Jewish Medical Center (hereafter KJMC), Department of Medicine (hereafter the Department).

I am writing to complain that I had been mistreated, abused, exploited, retaliated, and discriminated against after I started my medical residency at KJMC on July 1, 2006. I feel KJMC had wrongfully terminated my position based on wrongful accusations from chief resident Dr. Vajinder and Intensive Care Unit (ICU) Director Dr. Mukherji, and for retaliation, because previously I had pointed out the irregularities and mistakes the hospital and its employees had made. The reasons KJMC used in its May 22, 2008 letter to terminate my position were in my opinion unjustified and exaggerated.

Discrimination, Intimidation, and Retaliation

While residents of various religious backgrounds in KJMC could take time off to observe their holidays, KJMC had made it extremely difficult for me or certain other residents to take time off even when we became ill. There was a Chinese resident who could not get sick leave in November 2007, even when she had presented the physician’s diagnosis to the Department of Medicine. However, I noted a disturbing trend that residents who are from the same country as the program director often receive special privileges and escape their responsibilities without any consequences. For example, a PGY-3 resident who was from the same country as the program director did not show up the whole night on one day of April, 2008 for her night shift and she did not receive any questioning or disciplining. There was another resident who was also from the same country as the director, and used to be frequently late for work or left early before her shift ended. She was never questioned because she was a good friend of the program director.

Personally, the first time I took sick leave was on 10/19/2006. I was immediately warned the next day by the chief resident Dr. Sxxxx that I would be punished with two extra days on-call if I got sick again on the day I was on-call. This is in violation of ACGME rules. I had reported his threats to the Department of Medicine by sending an e-mail to the program secretary.

I was in the hospital on March 13, 2008, when I was again not feeling well, and asked for a sick leave of absence. The chief resident Dr. Silkov refused to grant me sick leave. In the afternoon, I felt worse with a fever and had called Dr. Silkov again. He referred me to the Associate Director of the Program Dr. Mark Russell. Dr. Russell asked me to go to Emergency Room (ER) for an examination. During the examination by an ER physician (Dr. Fxxx), another chief resident Dr. Vajinder had come to ER and asked Dr. Fxxx to do extra blood tests and X-rays on me although I was not his patient, technically violating HIPPA.

Later, when I sent a formal complaint letter on March 14, 2008 to the Department of Medicine regarding Dr. Vajinder’s intention to do unnecessary tests on me, I received a bizarre response from the Department and the KJMC. The associate director Dr. Russell had accused me of implying some kind of inappropriate relationship between the program director and the program secretary, because in the letter I had mentioned then resigning Governor Mr. Spitzer simply as a reference in the course of discussion, although I had never alleged any impropriety between the program director and anyone else. In fact, I never had any idea about any type of relationship between the program director and the program secretary at all. Still, Dr. Russell continued to escalate the issue by forwarding the letter to the KJMC Human Resources (HR), even though I agreed to withdraw my letter under his pressure. Dr. Vajinder during this time lied to the Department and KJMC by denying what he had tried to do to me in the ER. The HR instructed me on March 25, 2008 to send an e-mail to Resident Union (CIR) representative Mr. Bruce indicating that I was in fact too sick to hear Dr. Vajinder correctly, and as a result, the description of what happened in the ER in my previous letter was not true. This was the first attempt by the KJMC HR to try to label me as “being too sick” as it tried to force me to recant my account. It had tried again later to force me to admit to non-existing impairments and tried to place me on disability. Ultimately, the HR used false accusations to terminate my position on May 22, 2008. I was shocked by the HRs’ requirements, and refused to write the letter they wanted. Instead, in my e-mail to the Union representative Mr. Bruce, I repeated that my description about what happened in ER was true and accurate.

In a separate incident, Dr. Vajinder personally sought me out on May 15, 2008, accusing me that he had been looking for me for several hours in the afternoon and was unable to find me. He also accused me that the nurses and other residents were unable to find me in the morning. This was obviously not true as I had been working in the morning at the intensive care unit (ICU) as well as the ER, and also answered pages regarding consults and renewed orders for ICU patients together with the pharmacy in the afternoon, proving that I was easily accessible throughout the whole day. I told him he was lying for his false accusations, and more than one hour later, he retaliated by accusing me of threatening his safety by using hostile body languages. Yet when this was happening, we both were standing next to the security station, and Dr. Vajinder did not report the incident immediately to the security during our discussion, nor did the security intervene at any time during the discussion. It is therefore unlikely that I would have threatened Dr. Vajinder at all. As a result of Dr. Vajinder’s one-sided accusation, Dr. Mukherji, the ICU director, chose to believe his story without further verification with me, declared at ICU “we will take action (against Dr. Wang)”, and immediately restricted my freedom illegally by ordering me to stay in a small room in ICU next to the nursing station. I actually had to ask permission from Dr. Mukherji whether I could go home when my shift ended near 9:00 PM. Dr. Mukherji had repeated “we will take action (against Dr. Wang)” under different circumstance and had made it known to many medical residents while the investigation was not started yet, or still under way.

During the investigation of this incident on May 20, 2008, KJMC questioned me regarding my whereabouts on May 15, 2008 between 4:00 PM to 6:00 PM when I was in the hospital and functioned as a regular resident. When I could not give them exact timing of my normal activities in the hospital on May 15, 2008, the KJMC used this irrelevant event to accuse me of being a liar, and later terminated my position. (see the letter from KJMC). I should mention that I was interrogated without being informed of my legal rights prior. Before the interrogation, KJMC did not inform me about my civil and legal rights. KJMC did not make me aware that all my answers would be documented and could be used against me later. After interrogation, both Union and KJMC HR had tried to force me to admit that I had memory loss and impairment by telling me of non-existing evidence (which they never showed it to me, but I had documented in my e-mail).

I find there are also several incidents of hostility and discrimination directed specifically against certain residents. Dr. J Patel, a coordinator in the program, had once sent me back to the audience when I had just finished presenting the chief complaint of a patient in a morning report. I used the patient’s own words as classically taught in the textbooks to present the patient’s chief complaint. But Dr. Patel wanted me to use medical terminology to describe the chief complaint, which is unorthodox. This same Dr. Patel had once tried to have the Department terminate a Chinese resident, because he failed to write a progress note. It should be noted that many other senior residents did not write progress notes, but the same standard was not applied throughout, and the Department only tried to terminate this particular Chinese resident.

These incidents of hostility are by no means isolated but are pervasive through out the whole program. As early as November 10, 2006, when I tried to explain a patient’s situation to Dr. Hxxx, a pain management attending, Dr. Hinke rudely kept pointing her fingers in my face. When I requested her to stop pointing her finger in my face, Dr. Hxxx shouted at me, “Who are you?” I had told her that “I am a human”. Dr. Hxxx not only did not stop pointing her finger, but instead threatened, “I am going to write you up!” After I had reported the incident to the Department, complaining “Dr. Hxxx’s behavior and words hurt”, the Department found that I had talked and responded to Dr. Hxxxx properly and per program director Dr. Zahir concluded that, “Dr. Wang is a good resident”. Inexplicably, the Department still asked me to make an apology to Dr. Hxxx.

In April 2008, two Chinese medical residents were singled out by Dr. Vajinder, the Chief Resident who represented the Department of Medicine, for humiliation and mistreatment in front of all medical residents during a morning conference. The Chinese medical residents were denied a chance for an explanation. Usually, when we filed complaints to the Department of Medicine, such as the one I had done on March 14, 2008, the Department tried to cover up these discriminatory behaviors by intimidation and chose to listen to the one-sided story from Dr. Vajinder, and gave even more hard times to Chinese medical residents. The Department had a practice of intimidating medical residents by asking them to write an explanation, and then threatened the residents that all the explanation will go to their personal files and will affect their career throughout their lives. Thus, certain residents had to write an explanation for a minor mistake or even for no mistakes at all, while other residents who came from the same country as the program director did not have to explain anything even for much worse offenses. There was one such case in which a patient with severe hypokalemia was not prescribed potassium until he died.

This repeated pattern of unfair punishments and ill treatment towards certain residents is in direct violation per Accreditation Council for Graduate Medical Education, which states, “Nevertheless, sponsoring institutions and programs must provide an educational and work environment in which residents may raise and resolve issues without fear of intimidation or retaliation”.

Cruelty

After I was terminated on May 22, 2008, the KJMC and the Union had tried to label me as “not normal” and to entice me into admitting a problem with “memory loss” or “mental problem” without proper diagnosis so they could place me on disability. However, a formal diagnosis was never given. As I had mentioned above, this was the second time the KJMC HR and the Union had tried to label me as someone with “impairments”. They specifically tried to take advantage of my difficult family condition by pointing out that they will end my medical career, medical insurance, and income, unless I comply with their demand. They specifically pointed out that my wife currently has xxxxxxxx and I must support xx children. They did not care I am my family’s sole provider.

When I was wrongfully terminated, I knew the relationship had soured between myself and the Department beyond repair. I had asked the hospital and the Union to give me a chance to restart my career in another institution either as a medical resident or as a researcher. The hospital and the Union refused. They only allowed me either to claim impairment disability or to be terminated without a chance to find another residency position or research position. In other words, KJMC abruptly ended my hard earned career without recourse. Even physicians and nurses with severe violations of ethics and codes and having done great harm to patients in KJMC were granted a second chance, yet I was denied any chance to continue my career unless I admit to some vague and trumped-up charges that I was impaired, the details of which was never revealed to me. I should mention very strongly that despite their best efforts, KJMC had never, ever, been able to find any wrong doing on my part as a professional physician in patient care matters.

I find it ironic that despite the fact KJMC proclaimed I was impaired, they never specified exactly what my impairments were. Further, I question why they would continue to put an impaired resident continuously on the most rigorous schedule, especially when the resident was ill, and then claim all they care about is patient care or the resident’s health. The unethical behavior listed below also indicated some kind of cruelty to patients.

Unethical Behavior

I surmise that KJMC has for some time tried to dismiss me as a potential whistle blower. I had observed many irregularities and mistakes in patient care occurring in KJMC on a regular basis. Lying and falsifying records in medical charts were routine. The nurses, supervisors and directors had tried to cover their mistakes retroactively on a regular basis. I had previously documented some of them in medical charts and had reported some of them to the Department. I suspect the Department and the program had considered me as a ‘threat’ when I was trying to do the right thing for the patients. Given the recent incidents above, they felt this was the chance to terminate my training once and for all. Some examples of some of these unethical behaviors and mistakes include: Dr. Zahir had in fact asked me to see psychiatry when I had pointed out an incident in the ER when a patient was dying of hypotensive shock yet the patient did not even receive IV fluid; another example was the same ICU director Dr. Mukherji who confined me to a room also allowed a metal guide wire to be left in a patient’s body for several days, until it was found by a radiologist; in a separate incident, he also had a medical resident falsify the progress note after the patient was coded and became vegetative; I also note that it is not infrequent that nurses changed physician’s prescriptions. An example I observed was when nurses had given chemotherapy to a patient in 6 hours, instead of 46 hours, and later the prescription was changed to cover up this fact; I also noted nurses failed to honor the patient’s DNR and DNI order; patients were often restrained illegally after restraining orders expired; nurses had forced patients of advanced age to take sleeping pills while these patients were obviously competent and clearly refused; I knew of a case where blood transfusion was administered to a patient who clearly refused blood transfusion in writing; patients continued to fall to the floor repeatedly even after they were put on one on one observation and/or the risk of the fall had been pointed out to the supervising nurses; a nasogastric feeding tube was inserted to the left lung, and chest X-ray was not obtained afterwards, causing a delay in diagnosis until the next morning, etc. These examples are simply too numerous to list.

I can provide the proof for these allegations. What’s even more troubling, these incidents represent only a small fraction of some of the many which I personally had observed.

When I tried to carry out my duty as a training physician, do the right thing for the patients, or bring some of these issues or similar incidents to the attention of the Department and nursing supervisors, more often than not the Department and the hospital considered me as a “threat” to the hospital, placed enormous pressure on me, and tried to label me as a person with anger.

KJMC had also violated my wife’s privacy and HIPPA rights by making public my wife’s medical condition to many in KJMC after my position was terminated on May 22, 2008. My wife had been diagnosed with xxxxxxxx as mentioned above. Her medical condition was known only to a limited number of people in KJMC before May 22, 2008, such as her xxxxx, the program director, and the associate director. My wife and I had made an enormous effort to keep her condition as a private issue. Even my closest friends in the residency program had never known my wife’s medical condition, because making her condition known to the public could create difficulties for my family, children’s education, and ability to rent, etc.

Undoubtedly, KJMC will deny all of the above-mentioned problems. However, I can provide much evidence that lying and falsifying records were routine in KJMC. For example, the program falsified residents’ training records such as procedure logs and patient cases for evaluation. The nurses falsified progress notes, and ICU director asked resident to falsify progress note after patient was coded and became vegetative. The scale of unethical medical behavior in KJMC is deep, wide, and rampant.

It should be pointed out that right after May 22, 2008, there were many residents in the KJMC who had tried to sign an appeal asking KJMC to allow me to return to work. However, the Department chief resident Dr. Shazad intentionally spread word stating that “Dr. Wang will come back to work next Monday. There is no need to appeal”. Later, the Department chief resident Dr. Vajinder, had again spread word among medical residents saying that “Dr. Wang had reported our hospital to JCAHO (The Joint Commission on the Accreditation of Healthcare Organizations)”, trying to make those medical residents who are sympathetic for me turn against me.

KJMC had also stopped my payroll during the group bargaining between the union and KJMC, violating the contract between the union and KJMC, which said the employee's payroll should not be discontinued during the group bargaining.

Exploitation

Knowing that almost all its medical residents were originally from other countries, KJMC had exploited its PGY-1 medical residents by asking them to volunteer up to three weeks before the starting date (July 1), even though KJMC did not have any formal schedule for the volunteers, and did not provide compensation and/or medical insurance for the volunteers.

Conclusion

I feel my legal and civil rights have been violated. I have been falsely accused and charged, and my position unjustly terminated by an institution with discrimination, intimidation and retaliation towards me because I was trying to do the right thing. I presume my medical career has ended, although I have done my duty and adhered to principle of “doing no harm” as a physician towards my patients, which in my opinion, should be the greatest, if not only, barometer to judge a physician. I feel that I should do my part to uncover what has happened in the past at KJMC, so that abuses do not occur in the future, and patients and residents will no longer be mistreated.

To fight against KJMC is like King David against Goliath (the Giant). I need your help.






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