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 operates...as 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.