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Blaming the messenger: Parkland Memorial’s criticisms of our Ebola center story don’t stand up against the facts

My story raising questions about a Texas task force’s selection of Parkland Memorial Hospital and UT Southwestern Medical Center to head up a new Ebola treatment center has prompted a strange response from Parkland.

One of its senior executives accuses me in a press statement this week of bamboozling some of the most prominent health-care experts in the industry, and my news organization of trying to divide Dallas’ medical community.

First, some quick background. My Oct. 24 article featured three national experts on hospital management who in recent years have expressed concerns about Parkland’s approach to patient safety or transparency. Until late last year, Parkland and UTSW were at the center of a rare two-year federal safety intervention to try to remedy what regulators called life-threatening failures in infection control and other practices at Parkland. UTSW oversees the hospital’s clinical care.

After they were tapped as the operators of the newly created Ebola center, I naturally revisited that history in interviews with the experts. It’s my responsibility as a watchdog reporter to follow up on such issues. The professionals in turn questioned whether the task force had considered the safety record of both institutions. They also called for transparency about whether Parkland and UTSW have tackled the longstanding problems in their academic partnership.

Consultants and government officials have warned over the years that their differences - divergent missions, turf battles and clashing business interests - must be fixed to ensure effective patient care. Officials with Parkland and UTSW have not responded to our questions about those issues, highlighted in our 2013 Chronic Condition investigation.

Back to the Parkland complaint. Michael Malaise, a senior public affairs executive with Parkland, circulated an email to Dallas “opinion leaders and media” alleging that I had made false claims in my conversations with the experts intended to “coax a particular response from them.” He also accused The Dallas Morning News, whose ongoing investigation triggered the unusual federal crackdown, of being “obsessed with promoting discord” within the local medical community.

For the record, we understand the enormous task Parkland employees have confronted in overhauling their hospital’s operations over the last three years. But the public shouldn’t confuse our investigative reporting with promoting discord.

Also, the experts in my story weren’t in any way misled. To the contrary, they said they found my approach – and the story – fair and accurate.

Below, I respond further to the Parkland allegations:

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AG rejects Parkland Memorial Hospital’s secrecy effort

Parkland's new $1.3 billion hospital, seen here from Dallas Love Field, is set to open next year. (Michael Ainsworth/The Dallas Morning News)

For more than two years, Parkland Memorial Hospital has tried to protect fired or otherwise terminated employees. Now Texas Attorney General Greg Abbott’s office has rejected the effort.

When facing open-records requests for personnel records, Parkland’s standard practice since at least 2012 has been to tell ex-employees that they could object. It cited a state law allowing public hospital employees’ names and other basic information to be withheld if they detail specific safety concerns.

As I reported Saturday, the effort led to an Aug. 26 AG ruling that let Parkland suppress the name of a nurse who had been fired twice over patient abuse — and who had already been named in a News article.

My questions about the secrecy order led the AG to issue a corrected version over the weekend. The law that Parkland has been citing “does not apply to a former employee,” the new order says.

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Hospital experts question decision to place UTSW, Parkland at helm of Ebola center

UTSW and Parkland were tapped to operate a new Ebola treatment center, despite their track record of infection control failures. The center will be housed in an intensive-care unit at the Methodist Campus for Continuing Care in Richardson.

A Texas health panel’s decision to entrust the operation of a new Ebola treatment center to two Dallas medical institutions with a record of infection control failures has triggered questions from concerned national health-care experts.

They want to know whether Gov. Rick Perry’s Task Force on Infectious Disease Preparedness and Response even considered that recent history before installing them at the helm of the Richardson facility.

Until late last year, Parkland Memorial Hospital and UT Southwestern Medical Center were at the center of rare government safety intervention to try to fix what regulators called life-threatening breakdowns in infection prevention and other practices throughout Parkland, Dallas’ safety-net hospital for the poor. UTSW manages clinical care at the facility.

Regulatory violations have ranged from poor hand washing to filthy patient rooms with overflowing trash bins, excrement and blood. Turf battles between the two organizations over money, physician staffing and their divergent missions also have been factors in jeopardizing patient care over the years, we found in our own 2013 investigation.

But state officials aren’t saying whether the regulatory problems or the stormy partnership came into play during the rapid creation of the Ebola center in recent days.

Perry’s Texas Health and Human Services Commission, which helps coordinate the task force’s efforts, declined to answer questions about the decision, only giving the institutions a vote of confidence.

“They already have been training for the strict infection control procedures needed to handle a patient with Ebola,’’ a spokeswoman said.

Dr. Ashish Jha, associate professor at Harvard University’s School of Public Health, said the public needs an explanation.

“This track record of problems is of course concerning,’’ Jha said “A big question is have they (Parkland and UTSW) really put these problems behind them, and do they understand what caused them? It’s absolutely important for them to address this publicly.’’

“You would assume that the task force recognized the recent history and concluded that the two organizations will be able to work beyond past differences,’’ said Ranga Ramanujam a Vanderbilt University professor who studies organizational factors related to patient safety. He wants to know more about the decision process, he said.

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A message from Liberia to Dallas about Ebola

A medical worker sprays people being discharged from an Ebola treatment center in Liberia. (Associated Press/Jerome Delay)

A Liberian government official is sympathizing with Texans’ fear and anger about Ebola.

“We are not blaming people who feel the way they feel,” Gabriel Williams told The Dallas Morning News. “You know, you wake up one morning and you see your whole life being threatened when you feel that haven’t done anything. You’re at home and someone just came from nowhere and brought this on you.”

Liberia experienced the same plight, said Williams, spokesman for the small West African nation’s embassy in Washington.

“The virus did not emanate from Liberia,” he noted. “Someone brought it there and it spread.”

The World Health Organization says Ebola first appeared nearly 40 years ago in two other African countries, Sudan and the Democratic Republic of Congo. The virus is named for a Congo river near one of the initial outbreak sites.

The current epidemic began in Guinea before “spreading across land borders to Sierra Leone and Liberia,” WHO says. There have been “more cases and deaths in this outbreak than all others combined.”

Williams urged people not to judge Thomas Eric Duncan, the Liberian man who was diagnosed with Ebola shortly after arriving in Dallas. He died last week at Texas Health Presbyterian Hospital Dallas, where at least two nurses contracted the virus.

People in Liberia and the U.S. have accused Duncan of flying here despite having had close contact with an Ebola victim and knowing he might be infected. Duncan’s relatives have vehemently disputed that.

Williams said the matter remains unclear and added: “I would not jump to conclusions on any matter relative to whether or not he concealed information.” Continue reading →

Fired worker who claimed fraud loses suit vs. Dallas doctors

Defense attorney Tom Melsheimer called the lawsuit a "shakedown." (Fish & Richardson)

A prominent group of Dallas-area surgeons has defeated claims that it fired an employee for refusing to commit fraud.

Dallas County jurors ruled this week for Texas Vascular Associates and several affiliated doctors. The defendants successfully argued that billing coder Cortez Mills was fired for insubordination and abusive language.

“In Texas, we call this kind of lawsuit a shakedown,” said a written statement from defense lawyer Tom Melsheimer, a former federal prosecutor. “Ms. Mills was trying to intimidate our client with bogus claims, a self-aggrandizing media blitz, and the threat of bad publicity.”

Mills was fired in 2012 and filed suit later that year, represented by the law office of former federal judge Joe Kendall. Matthew Scott, one of that firm’s attorneys, said Thursday that he couldn’t show jurors a polygraph test backing Mills’ billing-fraud allegations.

“It was her word against four doctors who had a lot to lose,” Scott said.

In court filings, Texas Vascular said Mills had a criminal history that should have prevented her from being hired. She served probation for aggravated assault and credit card abuse, records show.

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Health regulators not rushing to probe Dallas hospital’s handling of Ebola patient

Texas Health Presbyterian Hospital of Dallas

Federal and state health regulators have yet to determine whether they will investigate why Texas Health Presbyterian Hospital of Dallas didn’t hospitalize a Liberian man when he first entered its ER last week.

Instead, Thomas Eric Duncan, whose home country is a hot spot for Ebola outbreaks, was released with antibiotics. It was only when he returned to the hospital two days later that he was diagnosed with the often fatal disease – the first such case identified in the U.S.

The Centers for Disease Control and Prevention characterizes Liberia as “active” for Ebola transmission, and it’s among the West African countries hardest hit. Texas Health Presbyterian officials said Tuesday that they were prepared for an Ebola patient. In a news conference, a hospital epidemiologist said the hospital has “had a plan in place for some time now in the event of a patient presenting with possible Ebola.”

But questions now abound about how meticulously caregivers screened Duncan for symptoms and assessed his risk as a Liberian.

“The immediate focus at this time is on managing the situation with this specific patient,” said David Wright, deputy regional administrator for the Centers for Medicare & Medicaid Services, the primary regulator of federally funded hospitals. “We need to let things settle down before determining what, if any, actions we may take.”

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Group claims students at risk from chemicals

Center for Effective Government's analysis of North Texas chemical risks

If a liberal advocacy group is right, every child in every school in Dallas County is within the danger zone of a facility storing extremely hazardous chemicals, according to a study issued today by a group pressing for greater restrictions.

So are a substantial share of North Texas’ other school children and, for that matter, the rest of us, according to the Center for Effective Government. The Washington-based nonprofit says its mission is to increase government accountability through transparency.

In most cases, the group said, there are safer, economical alternatives to the chemicals being used. Chemicals that make residents safer from industrial accidents or even deliberate sabotage by terrorists. The group has lobbied heavily to require the use of such alternatives. In addition to tougher rules, it has urged greater disclosure of risks to the public.

“A year and a half ago, the West, Texas fertilizer facility explosion destroyed three schools,” Sean Moulton, a policy expert with the group, said in a prepared statement.

“Since then, we’ve seen a number of other chemical disasters that have caused deaths, injuries, and major property damage. It’s time to get serious about keeping our kids safe – before a chemical catastrophe causes another tragedy,” he said.

The group gathered public information from Environmental Protection Agency offices around the country providing details of the risks self-reported by facilities and mapped which had risk zones that included public or private schools.

Those risks typically would not expose everyone in the potential area at once and are not necessarily life-threatening.

The facility that poses risk to the largest number of North Texas school kids is the Central Regional Wastewater System plant in Grand Prairie, the group said.

More than 1,200 schools and 750,000 school children are within the area where they might be affected by the sulfur dioxide used there were released, according to the group.

The group released a similar study in the wake of the West explosion that looked at how many schools were within 1 mile of facilities required to report the possibility of off-site consequences to the Environmental Protection Agency.

That study figured in discussions and Congressional hearings about actions to take in light of the West explosion.

In this case, the group found more students by including all those within the range even though it looked at smaller number of facilities had self-reported posing the greatest risks.

The Dallas Morning News did not review the group’s analysis. Last year, The News did use related data from the group when reporting that a third of the 1,347 Texas plants that file emergency plans with the EPA because they handle “extremely hazardous substances” either reported having had no outside inspections or, like West Fertilizer, reported either no safety inspection or no safety inspection by a government agency.

The News also found, in its 9-month investigation of issues related to the West explosion that lax regulation of the explosive there, ammonium nitrate, is rampant and that 20,000 Texas live within 1 mile of a facility storing 10,000 pounds or more of that one chemical.

While there is a potential for release, officials at the Trinity River Authority – which runs the Grand Prairie sewer plant — said they’re confident they have plans in case to address them.

“I can assure you that that’s the case, and that we routinely go over that and make sure that we’re ready to go. We have all the proper equipment and all the proper procedures readily at hand for the responders we’ll have,” said general manager Kevin Ward.

Ward also said the authority is actively evaluating changes to its plants that could reduce or eliminate the use of specific dangerous chemicals.

“We are doing the engineering evaluations,” he said. “A lot of those are more costly but they may be worth the cost.”

Ward declined to comment on the group’s specific numbers, citing security concerns.

The Grand Prairie plant is one of 59 facilities nationwide the group said had 200,000 or more students potentially affected in the worse case. Only one facility in the country — a Kuehne Chemical Company plant in New Jersey — had more students within the range of danger.

Dallas and Rockwall were among the 102 U.S. counties (about 3 percent) where every student faced risk from at least one chemical facility.

Overall, Texas school kids were among the most likely to go to school in risk zones: 61 percent attend a school within the are of possible off-site consequences, the documents collected by the group show.

Texas has among the highest proportion of students in such zones in the U.S. Nationwide, 1 in 3 students attend a school within such a zone. The study was conducted by the, a liberal advocacy group that has argued for increased safety rules and disclosure to communities on the use of dangerous chemicals for which safer alternatives exist.

For more information from the group, check out its Web site.

Dallas police and fire pension chairman addresses $196M loss

Last week came the story of how the Dallas Police and Fire Pension System lost $196 million on various risky real estate development projects in recent years. Pension board chairman George Tomasovic has posted a response on the fund’s web site.

Dear Fellow Police Officers and Firefighters: You may have read the recent news about our losses in real estate. While these numbers are generally accurate, I can tell you these figures were not news to me or to my fellow Trustees. We have known about these losses. There is no doubt some of these investments did not turn out as well as we had hoped. But your Board has already begun working with the staff and our consultants to rework our real estate portfolio…

See the entire post here.

Dallas police and fire pension officials traveled to upscale Napa wine country 45 times and lost $46 million

Dallas police and fire pension officials traveled to the Napa area 45 times to oversee a speculative real estate venture that lost $46 million.

See my story in today’s paper for more on this. The Napa loss is part of nearly $200 million the fund lost to a succession of risky real estate ventures in recent years.

I’ve gotten a couple of calls and emails today from people interested to know more about fund officials’ travel. You can check out where they went in the interactive below, which tallies their trips from 2009 to 2012. And check out two stories by me and Gary Jacobson last year. One on the travel and another on the real estate ventures.

Here are the pension system’s travel expenses (for due diligence and continuing education) from 2009 to 2012:

2009 – $316,412
2010 – $247,187
2011 – $212,985
2012 – $185,000