Medscape.com REPORTS HERE that "The Texas Medical Board (TMB) has charged a family
physician at the center of a nationally
publicized whistle-blower case involving 2 nurses, with poor medical
judgment, nontherapeutic prescribing, failure to maintain adequate
records, overbilling, witness intimidation, and other violations." You can read our full report on the background of this case in our ARTICLE REPORTED HERE.
"The charges follow a report that the 2 nurses — Anne Mitchell, RN,
and Vickilyn Galle, RN — made anonymously to the TMB last year about
patient care rendered by Rolando Arafiles, Jr, MD, at Winkler County
Memorial Hospital in Kermit, Texas, where the 2 nurses and Dr. Arafiles
worked."
"After the TMB contacted him about the report, Dr. Arafiles asked the
sheriff of Winkler County to investigate its source. The sheriff, the
physician's acknowledged friend and patient, traced the report back to
Mitchell and Gale, who were then charged in a state court with misuse of
official information, which is a third-degree felony."
"The charge against Galle was dropped, but the hospital fired her as
well as Mitchell. In February, a jury found Mitchell not guilty in less
than an hour, rejecting the prosecution's argument that she blew the
whistle on Dr. Arafiles as part of a personal vendetta."
"In a complaint filed last month with a state administrative court,
the TMB charged Dr. Arafiles with 9 instances of substandard care. In 1
case, the TMB stated, he sutured part of the rubber from suture-kit
scissors to a patient's torn and broken thumb (in his trial testimony, Dr. Arafiles said he was
attempting to stabilize the fracture). And when another patient was
admitted to the hospital for an abscess caused by methicillin-resistant Staphylococcus
aureus, Dr. Arafiles rubbed an olive oil solution — not on the
hospital's formulary and not approved by the US Food and Drug
Administration for this purpose — on the abscess, according to the TMB.
The nurses had reported to the TMB that Dr. Arafiles promoted the use of
herbal medicines."
"The TMB also alleged that Dr. Arafiles:
- diagnosed hypothyroidism in 1 patient
without any testing and diagnosed the same disorder in a second patient
despite normal thyroid function tests;
- prescribed hormone replacement therapy (HRT)
for a woman whose lab work showed testosterone, estradiol, and
progesterone levels within the normal range — HRT was contraindicated
for the woman because of a history of deep vein thrombosis, which
reoccurred after HRT was initiated;
- performed and billed for unnecessary
genitourinary exams;
- failed to adequately document the care he
provided; and
- engaged in witness intimidation regarding
the 2 whistle-blowing nurses."
"The attorney representing Dr. Arafiles in the TMB action, Jennifer
House, told Medscape Medical News in an email that her client 'certainly denies that he engaged in any questionable medical
treatment.' House also wrote that Dr. Arafiles had a constitutional
right to 'to seek the involvement of law enforcement personnel with
regard to the actions of the nurses in question' and that the decision
to criminally prosecute them was not his, but 'a matter of discretion
among law enforcement personnel.'"
"The TMB complaint against Dr. Arafiles represents his second run-in
with the board. In 2007, the TMB placed a 3-year restriction on his
license after determining that he had failed to adequately supervise a
physician assistant in his work at a weight-loss clinic and to 'make an
independent judgement' about protocols that the clinic owner had
developed for treating obesity."
"The board fined Dr. Arafiles $1000 and prohibited him from
supervising or delegating prescriptive authority to physician assistants
and nurse practitioners, as well as supervising a surgical assistant.
He was ordered to complete continuing medical education in ethics,
medical records, and the treatment of obesity."
"In the midst of his current dealings with the TMB, Dr. Arafiles is a
defendant in a civil suit filed by nurses Anne Mitchell and Vickilyn
Galle in federal court. The nurses allege that Dr. Arafiles, their
former hospital, and county officials had violated, among other things,
their freedom of speech. The defendants deny any wrongdoing in the case."
"The Texas Department of State Health Services also proposed imposing a
$15,850 fine on Winkler County Memorial Hospital in April for
violations involving an unnamed physician who matches the description of
Dr. Arafiles. Part of the proposed fine stemmed from the hospital
having fired 2 employees who submitted a physician's patient records to
the TMB."
