An Open Letter to the New Chief Quality Officer at Brigham and Women’s Hospital: On Gynecological Negligence at BWH.

Andrew Resnick MD. New Chief Quality Officer at Brigham and Women’s Hospital

Dear Dr. Resnick,

I recently found out that you were named the Chief Quality Officer at BWH.

Congratulations, old friend!

Of course, as a past colleague at the University of Pennsylvania, a co-resident in surgery at the Hospital of the University of Pennsylvania, an attending surgeon and, I think, as a friend to my wife, Dr. Amy J. Reed and me, I am delighted to know that reason can prevail at BWH — perhaps.

I certainly know you recall Amy as one of the interns on your surgical service at Presbyterian Hospital at Penn — and then as a notable and capable resident in anesthesiology and fellow in critical care at HUP.

(But, who knows — perhaps it’s not about knowing. Perhaps politics taints all men.)

Andy, I am certain that you know about how Amy was harmed and killed by a deadly error of negligence on the part of BWH gynecologists — when her “missed” uLMS was disseminated throughout her abdominal cavity using a defectively designed and dangerously marketed STORZ Power Morcellator device at Brigham. And I know, with near certainty, that you have studied and followed the national campaign she and I waged at FDA and elsewhere to eliminated Laparoscopic Power Morcellators (LPM) and Morcellation from Gynecology.

Amy died in May 2017 from complications of abdominal sarcomatosis due to the spread of her uLMS using a STORZ LPM device by one of the MIGs at Brigham. And as I am sure you know, we are currently litigating the BWH and STORZ for negligence and inadequate development/marketing of a dangerous product that caused the wrongful, premature or unnecessary, death of my wife and others. This litigation is ensuing relentlessly because of the radical incompetence of the corporate leaders and risk managers at BWH, CRICO and STORZ in sizing up the magnitude of negligence at hand.

I write this letter to you, not in your capacity as someone I knew in my past life. Nor do I write because I think you will be able to overcome the destructive and weak political forces within BWH or Partners Health. Rather, I am writing you this letter as a warning, in your capacity as a General Surgeon at BWH, a Chief Quality Officer and an institutional guardian at the BWH now.

Robert Barbieri MD. Chairman of Gynecology at Brigham and Women’s Hospital in Boston

Andy, BWH’s department of Gynecology is in need of immediate restraint and restructuring. I promise you that in the near future the specific illegal and unethical complacency exhibited by gynecological leaders at BWH will be put on full display for the public to see. That these persons remain in their leadership positions within the BWH Gynecology department is simply astonishing. In no other corporate setting or profession would illegal and unethical actions like theirs be tolerated — much less rewarded by leadership titles and professorships.

But aside from my opinion of these leader’s misconduct, which I know you will see in the press sometime in the next year, it should concern you that BWH gynecologists continue to adhere to a dangerous practice pattern in the management of uterine tumors in women.

As a HUP trained general surgeon, I know you recognize that no tumor with malignant potential should ever be disrupted inside a human body cavity — especially when NO attempt is made at ruling out a malignancy with any degree of certainty using tissue biopsy pre-operatively. That the LPM device is no longer used at BWH, and other Partners Hospitals, has only driven the BWH MIGs to revert to manual morcellation practices, which in the case of “missed” cancer diagnoses continues to pose a risk of upstaging and sarcomatosis.

Jon Einarsson MD. Chief of the Division of Minimally Invasive Gynecology at Brigham and Women’s Hospital.

Currently, at BWH and other Partners Hospitals, women with uterine fibroid tumors are undergoing morcellation operations in containment bags whose leakage rate has been shown to range anywhere from 9%-40% — as delineated by BWH gynecologists themselves. This is an unacceptable mortality risk from iatrogenic cancer upstaging, which as BWH’s Chief Quality Officer and a surgeon you cannot accept.

Andy, to morcellate a tumor with a known malignancy risk on the order of one in 200, or more, inside containment bags that exhibit a 9–40% leakage rate is a dangerous and intolerable breach of safe surgical practice and an error of logic and clinical judgement — especially when NO reasonable attempt is being made at ruling out a cancer pre-operatively using tissue biopsy.

I am certain that you understand my statement above, profoundly, as a surgeon — you were trained by Professors of Surgery like Ernest Rosato, Jeff Drebin, Douglas Fraker, Jon Morris and the others we both know. Would any of them take a potentially malignant tumor and deliberately chop it up inside a patient body cavity without making a best attempt at first ruling out a cancer using biopsy? NO WAY!

Andy, I’ve been at the Brigham. I know many of the characters there. I know the fierce politics of complacency, protectionism and back-stabbing at work at that institution when it comes to professional egos and money— and also how the politicians and money managers in charge routinely over-rule the real clinicians of substance.

But, since I heard you are there and I know that you will read this letter and remember me, and who Amy was, I have a few recommendations to you and your colleagues in BWH administration. Please take these seriously. I make these suggestions as a friend to the institution, as unlikely as that might sound at this point in time, in the interest of high quality care for women like my wife, and in the name of Dr. Amy Josephine Reed.

Here are my suggestions:

1. recommend the demotion or firing of the current Gynecological leadership with any hand in ignoring or suppressing the danger of LPM devices from patients and FDA — before the case of Mrs. Erica Kaitz is tried in Boston this coming Spring. These leaders are embarrassments as BWH physicians and as moral men — their conduct in handling the deadly hazard of morcellation was negligent and illegal, yet they remain in leadership at BWH.
2. Expunge the descriptor “occult” from the gynecological vernacular at BWH in referring to uterine soft tissue tumors. Andy, the diagnoses the Gynecologists at BWH (and elsewhere) are “missing” because they do not rely on tissue biopsy, are NOT “occult” — they are “missed”.
3. Establish strict tissue biopsy protocols at BWH, to rule out uterine soft tissue malignancies with a reasonable degree of certainty in cases where a “non-oncological” uterine resection, or a myomectomy, are deemed necessary. I am certain that a few solid clinicians like Professor George Demetri, Suzanne George, Marissa Nucci and Scott Swanson at BWH and DFCI will all be able to provide cross-disciplinary understanding of how this is imminently feasible to do. I am sure, you yourself, understand this!
4. Restrain BWH and CRICO’s defense attorneys from doing any further damage to your new institution’s reputation by continuing their useless legal defense in the Kaitz and Reed cases— it is highly likely that they see all the legal wrong-doing at this point in time, but continue to defend the indefensible conduct of their clients. It is my opinion that these defense attorneys are now operating in unethical, if legal, space and your institution will end up paying with terrible negative publicity and for their MASSIVE legal mis-measure. I know you understand the magnitude of damage Amy’s death has done to my family, whom you knew and saw growing while we were at HUP. And I certainly know you understand what iatrogenic abdominal sarcomatosis from Power Morcellation looks like when it kills a young woman, as a HUP-trained surgeon.

Andy, here’s your moment of leadership my friend. It’s not about politics or titles or just keeping the peace with a suit on…It’s about the truth.

And if you do not act on the truth, you will be no better than men like Stan Ashley and Ron Walls — institutional defenders who do not remember the truth or their responsibility to it as physicians.

Remember Amy and remember me , Andy— and know that if you do not act now in your new position of power to fix a major breach in quality and ethics at BWH, there will be many who will not respect what you are among those who are watching you ascend to Boston’s Ivory tower.

Do consider this letter from an old friend to be an opportunity for you to speak up and to lead as men of integrity would — men whose names are remembered as good men.

Your HUP colleague,

Hooman Noorchashm MD, PhD (For Amy and the others.)