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Sunday, May 25, 2008

Human Guinea Pigs, Sham Peer Review, and the Governor II

Introduction: Please take a look at part one of this series prior to reading this part.

The video linked here includes testimony from Tim Goosby, a nurse anesthetist, in front of Congress just a couple weeks back. Mr. Goosby is an independent registered nurse anesthetist.

Goosby's story starts in in mid 2003 when he was approached by the CEO of Cuero Community Hospital, Jim Buckner, to become the new nurse anesthetist. Cuero Community Hospital is the lone public hospital in Cuero, Texas. Cuero is a small town of only a few thousand folks, mostly Hispanics, poor, and many times illegal. The job offer came with one caveat. The hospital's other nurse anesthetist, Mark Crawford, had recently been caught stealing drugs as well as overbilling Medicare. While these were serious violations of ethics and standards, Crawford wasn't going to fired. Rather, after undergoing psychological evaluations, a temporary leave, along with other punishment, Crawford would return to the hospital and they would share duties.

Within a few month's of Crawford's return to the hospital, Goosby was approached by multiple nurses with new claims that Crawford hadn't changed his behavior. In fact, now the nurses claimed that Crawford was even doctoring prescriptions that Goosby had signed. Goosby immediately approached Crawford with the accusations.

Crawford immediately denied everything. Goosby demanded that he see all of Crawford's patient records. To this, Crawford replied

you will never see the patient records

Finally, after enough grilling, Crawford admitted to everything he was accused of. Goosby immediately went to the CEO, Jim Buckner, with what he had found. Buckner decided to arrange a meeting of all the hospital medical staff so that Goosby could present his evidence to them.

At the staff meeting, a small group of doctors, headed by Dr. Daniel Dugi and Dr. Tim Spradlin, continued to ask the same question of Goosby. Did he tell anyone outside of the hospital what he discovered about Crawford? Of course, he hadn't yet. The next day after a mysterious meeting with Dugi and Spradlin, Mark Crawford left the hospital as well as the town of Cuero never to be heard from in those parts again. (Of course, he later resurfaces in other parts of Texas as the link clearly shows).

As Goosby later found out, Dr. Dugi along with Dr. Spradlin, lead a pseudo mafioso group of doctors that became the de facto rogue administration, and the real administration was too weak to do anything to stop them. The next few months were a living professional hell for Tim Goosby courtesy of Dr. Dugi and his group of medical mafioso. They spread rumors attacking his character. They tried to turn the rest of the staff against him. All of these things were much easier to do given that Goosby was the "new guy" while Dugi, Spradlin, et al had each been at Cuero for many years. Furthermore, Goosby was now doing the work of two nurse anesthetists he was being worked to death. Cuero, like most hospitals, needs the staff's approval before any new medical staff member is hired on. Of course, Dugi made sure than no new nurse anesthetist was hired on.

Within months, Goosby found out why he was being targeted so viciously. Several nurses again approached Goosby. They claimed that Dr. Dugi was making them perform illegal drug tests on patients. Dr. Dugi was associated with a company called Activ Group, Inc. and the two entities had formed a partnership to bring the drug Providex to market. Only, according to the nurse, they weren't going through normal FDA channels to test the drug, but rather they were using the patients at Cuero as human guinea pigs.

Goosby immediately took what he learned to the hospital CEO, Jim Buckner, as well as the head of nursing at Cuero, Judy Krupala. His concerns were rejected by everyone he approached.

Meanwhile, in mid 2004, he was sent in to perform a fairly standard anesthesic procedure. A patient, who also happened to be a fellow nurse at the hospital (obviously due to doctor patient privilege the name can't be revealed), was undergoing a biopsy on his chest. Goosby was sent in to administer the anesthesia. The standard procedure in such a case for the nurse anesthetist to do two things prior to administering the anesthesia: 1) explain the consent form and have the patient sign it and 2) explain the assessment form and have the patient sign it. Goosby insists that both of these things were done just as they were done in thousands of procedures he performed prior.

Within months, this same nurse/patient accused Goosby of not providing these two forms to them. Goosby insisted to the CEO that of course he did, and he even provided the signed consent forms. The CEO backed up Goosby, however at the behest of Dugi the matter was still referred to the Texas Board of Nursing. This started an ordeal for Goosby that continues today.

What Goosby found in the TNB was an organization no less corrupt than the hospital that referred him. Unfortunately for Goosby, he had a DUI charge from a few years earlier that he failed to report to the Texas Nursing Board when he first went to work in the state. While this is a legitimate charge the normal penalty for such a failure is $250. Instead, this charge was used as the basis of what eventually lead to Goosby having to surrender his license in Texas for a year.

After receiving formal written charges, Goosby faced the board in an oral hearing known as an Informal Settlement Conference. Despite presenting the board with copies of the two forms in question and having the patient recant their story under examination, the board still ruled against Goosby. Instead, the TNB used his failure to report the DUI as the subject of an order to remove his license. Of course, such a draconian punishment goes against their own guidelines. (as I said earlier, such an infraction normally results in a $250 fine)

Goosby appealed the decision to a law judge. (this is standard procedure) In front of the law judge, Goosby's attorney referenced a prior decision, Turner Vs. Texas Board of Nursing, in which another nurse was similarly punished outside the guidelines of the case. The law judge sided with Goosby, however there is a serious problem in the manner in which the TNB Goosby would soon find out. While the law judge can make their ruling, the TNB doesn't have to accept that ruling. Ultimately, what they say is final, and the judge's ruling is only meant to be used as a guide. Of course, in the case of a corrupt board, like the TNB, such a rule puts far too much power in the hands of the corruptors.

Thus, despite having the ruling of the law judge on his side, Goosby was stuck. He could continue to appeal his punishment to the same law judge but the same corrupt nursing board would continue to reject that ruling and insist on their own. In the meantime, the long legal battle had drained nearly all of his financial resources. In fact, at one point, Goosby was approached by the TNB attorney, Liz Higginbotham, and told that they were determined to remove his license, and that he could either surrender it while he still had money or when he was broke. Goosby agreed under the condition that there be no mention that he administered anesthesia without consent or advisement, the two significant charges. Thus, in 2005, Tim Goosby lost his license to practice nursing in Texas for failing to report a prior DUI to the board.

Finally, after nearly two years of fighting the TNB, Goosby agreed to surrender his nursing license in the state of Texas for a period of one year. Of course, this opened up its own pandora's box. Once his license was removed in Texas, other states began to ask questions as well. Suddenly, his license was being threatened in a number of states including: Illinois, Colorado, and his home state of Wisconsin. Defending himself in all of these other states put further financial hardship on Goosby.

Nearly broke, Goosby was given a carrot by the state of Wisconsin. If he got his license restored in Texas, he would be allowed to work in Wisconsin. Of course, he needed to go back to the same corrupt TNB to do it. Through his attorney, he reached out to the TNB. The TNB agreed to restore his license under one condition. Goosby had to face the board and he couldn't speak.

At the hearing, the board once again accused him of administering anesthesia without consent or advisement, two things they promised to remove from his record, and then took it a step further. They now accused Goosby of being a drug addict. In his re instatement order, Goosby was accused of a laundry list of misdeeds including drug use. He was given 90 days to sign the order.

Upon the advice of colleagues, he was told under no circumstances to sign the order. Signing it would be a death sentence to his career. As soon as that order was posted on the TNB site, his license would be threatened by every other state. Instead he was told to reach out to the media. That is what he did.

As such, he became the main source for this investigative series by KPRC of Houston investigative reporter Stephen Dean's expose of illegal drug testing at Cuero Community Hospital. While Dean was painstaking in his coverage of Dr. Dugi's illegal drug testing, the corruption perpetrated at the TNB to Goosby became nothing more than an afterthought in the story.

That nurse, Timothy Goosby, is now licensed to practice in Minnesota. He said he surrendered his Texas nursing license and was forced out of his job at Cuero Community Hospital in retaliation for reporting the drug testing.

He surrendered his license for failing to disclose two drunk driving arrests when he applied for his Texas license. He told Local 2 Investigates the infraction was only discovered when the people involved in the drug testing started filing several accusations against him in response to his being a "snitch."

While Goosby refused to sign the order, the TNB put it up on their site regardless. In an ironic twist of fate, this lead to small bit of redemption for Goosby. The charges were so serious now that many other states did thorough investigations. As such, what they found was what you are reading...that the TNB orchestrated on Tim Goosby a sham peer review. In fact, the state of Illinois used the term "railroaded" in describing the case. The state of Wisconsin allowed Goosby to work in the state though his prior license revokation makes him a significant insurance liability.

Meanwhile, Jim Buckner waited until 2008 to finally speak on the record about some of the things that happened at Cuero Community Hospital. That just happened to be the statute of limitations on many of the crimes he witnessed. In the Dean expose, Buckner said that he left the hospital as a result of what he saw there regarding the drug testing. (It just apparently took him nearly five years to see it) He was replaced as CEO by a gentleman named Darly Stefka. Stefka was the head pharmacist at Cuero when the illegal drug testing was going on.

The pharmacist in charge when the drug was first added to the "formulary," or list of medicines being dispensed to patients by the hospital, has now been elevated to CEO of Cuero Community Hospital.

Darryl Stefka, Cuero Community Hospital's current CEO declined to answer questions on camera, but he insisted the drug's use was "very legitimate." When asked whether it was tested on patients without their knowledge, he answered, "I'm sure they knew."

Mark Crawford popped up on the radar of the TNB in 2007, Crawford was caught at a hospital in El Paso doing many of the same things that he did at Cuero. He was let off with a warning and a fine. There is one case that you won't find on the TNB site. Bridget Hughes was caught stealing 50 triplicate prescriptions, forging signatures, and using them for her own use. For this, her license to write prescriptions was removed for one year, but she was still allowed to keep her license to be a nurse. Hughes was the head nurse for Dr. Keith Miller, former head of the Texas Medical Board Disciplinary Committee. The disposition of her case has "mysteriously" been removed from the TNB site. (though as soon as I figure out how to transfer my copy from PDF, it will be placed back up on the internet)

Finally, Goosby took his pleas all the way to the governor's office of Rick Perry. Goosby pleaded with the governor's office to have the TNB investigated. According to a letter dated May 7, 2008, Dede Keith, (click download original attachment) in the communications office, told Goosby that the governor's office would share Goosby's concerns with Katherine Thomas, head of the Texas Board of Nursing. In other words, the Texas Governor's office thought it would be appropriate if the exact same corrupt TNB investigated itself.

Here is part three and the conclusion of the piece.


Anonymous said...

I find it very interesting that yoiu have not done any investigation into whether Goosby's claims are accurate. Furhtermore you have done zero investgation into the background on the products and individuals involved. Mr. Goosby lost his licence for lieing on his applications to the Texas State Board and subsequently to the Colorado State Board. Mr.Goosby has a certified record as a drunk with numerous charges against him in the State of Wisconsin. Go visit and begin to visit the other side of this individual. In very short order Mr. Goosby and the media companies involved will be under oath in a different venue in Texas it will be interesting to see what happens when he and Buckner and KPRC are held to a higher standard than smearing others without recourse.
The story is far from over.

mike volpe said...

Here are a few things I find interesting. First, I find it interesting that one IP address would scour my story all over the internet for nearly one full day and then suddenly there is an incendiary comment against Goosby. I suppose it is mere coincidence that an IP address from Oklahoma read my story here, Red State, and from Power Line, and keep reading it over and over and now I find this incendiary comment.

Second, I find it interesting that you can read my mind. I don't know how you could know what research I did or didn't do. Yours is not the first anonymous, incendiary comment against the subject of one of my pieces. In fact, it is SOP. It happened in this story about Dr. Blake Moore...

It happened in multiple stories about Grady Hospital...

Now, it is happening with this story.

Whatever Tim Goosby did or didn't do, it isn't nearly as bad as Mark Crawford and Bridget Hughes. Each of them not only lied but lied about much more significant things than a previous DUI. Neither of them lost their license. Hughes doctored phony prescriptions in order to feed her drug habit and she admitted as much, and all that happened to her was losing her ability to write prescriptions, which of course she subsequently did illegally anyway.

Second, Goosby has already testified in front of Congress. I don't know what venue you think he will be in front of but it doesn't get any bigger than Congress, and he is under oath there, and that is linked in my story. is a site started by many of the folks mentioned in my story, so while it is the other side, you should also disclose your obvious agenda.

Anonymous said...

Let him who is without sin, cast the first stone.
Somehow I don't think the slander against Tim is coming from someone who can cast stones.
Maybe it is more like, the guilty dog that barks first.
Mike and Tim have my respect.
Evil can only triumph if the good men do nothing. Way to go Tim!

Anonymous said...


Anne Brose said...

I have met Tim through the Semmelweis Society (the original group, not the take-over thugs). Tim strikes me as a sincere, honest former nurse who lost his license due to HQUIA (Health-Care Quality Inprovement Act). However, I have come to know many other members of the original Semmelweis Society, and I would say that most of these members have some sort of REALLY BAD personaility disorder that complicates his or her case to retain his or her medical license. Check out the case involving Blake Moore (put Blake Moore and Yankee Doctor in Google, which brings up another blog entry in this "Provaceteur" series. Blake has some MAJOR problems with mental stability, if this story and the commentators are accurate).