Opinion ID: 216587
Heading Depth: 2
Heading Rank: 1

Heading: ACH Revokes Dr. Bissada's Medical Staff Privileges

Text: In November 2006, ACH's Vice President of Patient Care Services Sandra Taylor, R.N., told Medical Director Dr. Bonnie Taylor about certain concerns she had about Dr. Bissada's practice. Sandra Taylor's concerns related to patient care and outcomes, specifically alleging (1) lack of communication with patient families, (2) repeated surgical and clinical cancellations, (3) complications resulting from delayed surgical proceedings, and (4) lack of confidence in Dr. Bissada's abilities. Pursuant to ACH's bylaws, Dr. Bonnie Taylor brought the matter to ACH's medical staff executive committee (executive committee) which held a special meeting and appointed an ad hoc committee, consisting of Chief of Cardiac Surgery Dr. Robert Jaquiss, Chief of Anesthesia Dr. Timothy Martin, and Dr. Robert Lyle, to investigate the allegations. The ad hoc committee began its investigation on November 30, 2006. The committee reviewed the records of eighteen of Dr. Bissada's patients, the results of his Press-Ganey surveys, [3] and clinic attendance and cancellation data. On December 6, 2006, the committee interviewed Dr. Bissada. During the interview, committee members asked Dr. Bissada about delays between the decision to perform a surgery and the performance of that surgery; complications arising from hypospadias repairs; Bissada's clinic cancellation rate; patient family complaints; on-call coverage; and the removal of labia adhesions in the clinic without anesthesia. Bissada v. Arkansas Children's Hosp., 2009 WL 1010869, at  (E.D.Ark.2009). On December 12, 2006, the ad hoc committee issued a report, making a number of negative findings about Dr. Bissada, including: 1. Dr. Bissada's consistent delays in the performance of surgical procedures lead[] to questionable outcomes. 2. Dr. Bissada's lack of communication with both local physicians and parents is a problem. 3. The cancellation rate for Dr. Bissada's clinic is excessive and unacceptable. 4. There is [a] lack of an effective mechanism for completeness of patient follow-up on Dr. Bissada's practice which results in patients becoming lost. 5. The rate of complications in Dr. Bissada's cases, based upon our review, seems to be more frequent than we would ordinarily expect. 6. These issues indicate a general lack of judgment on the part of Dr. Bissada. The ad hoc committee recommended referral of the eighteen cases to an outside reviewer[,] specifically a pediatric urologist, for further review. The executive committee extended Dr. Bissada's hospital privileges, which were set to expire on December 31, 2006, for one month, and sent the eighteen cases to Dr. Anthony Balcom, an outside pediatric urologist, for review. See id. On January 9, 2007, Dr. Balcom returned a seventeen-page review, concluding (1) the charts showed a pattern of highly irregular scheduling activities, (2) Dr. Balcom could not comment on Dr. Bissada's complication rates because he did not know how many of each type of procedure Dr. Bissada performed during the time period covered by the charts, and (3) the complication rate after pyeloplasty in terms of recurrent obstruction is concerningly high. The executive committee met that same day and voted to revoke Dr. Bissada's medical staff privileges. The next day, January 10, 2007, ACH notified Dr. Bissada his privileges were revoked and that he was entitled to a hearing to appeal the revocation. Dr. Bissada retained counsel and requested an appeal hearing before the executive committee, which was eventually scheduled for August 20, 2007.