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One of the Google hits for "Felix
Freshwater MD" is to the NY State Department of Health.
The following correspondence offers an explanation of how and why I was disciplined by the
States of New York and Florida for a set of circumstances that began in 1995 and what the reaction of other
physicians was to this. As the late U.S. Supreme Court Justice Louis Brandeis wrote, "Sunlight is the best of disinfectants".
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February 22, 2005
Dear Dr. Freshwater:
The
American Board of Plastic Surgery, Inc. has recently learned that your
license to practice medicine "in a state, territory, or possession of
the United States or by a Canadian province" has been reprimanded in
the past and currently assessed with a non-disciplinary citation.
Restrictions/sanctions
or issues of any kind to a Diplomate's medical license must be reported
to the Board for consideration by its Ethics Committee. Please provide
information concerning your license restriction in a detailed report
addressed to the Board and directed to my attention at the above
address. Failure to respond may in and of itself be cause for
additional disciplinary action by the Board.
Very truly yours,
R. Barrett Noone, M.D.
Executive Director
March 3, 2005
R. Barrett Noone M.D.
Executive Director
The American Board of Plastic Surgery, Inc.
1635 Market St. Suite 400
Philadelphia PA 19103-2204
Dear Dr. Noone:
I
am responding to your letter of February 23, 2005. You requested that I
provide you with "information concerning [my] license restriction".
My
licenses to practice medicine have never been restricted in any way.
However, I have been fined and reprimanded by the Florida Board of
Medicine because of Miami Children's Hospital dismissing me from its
medical staff in 1996 and fined reprimanded and censured by the New
York State Department of Health because of the Florida Board's actions.
These are the facts and circumstances concerning the actions by Florida and New York:
In
1995, a now defunct hospital called Deering Hospital reported me to the
National Practitioners Databank and to the State of Florida Agency for
Health Care Administration (AHCA). Deering alleged that I had resigned
from its staff while under investigation for substandard patient care.
In early 1996, AHCA began its own investigation. Under Florida law, any
AHCA investigation must remain confidential until its conclusion. AHCA
required me to sign a confidentiality agreement prohibiting my
discussing the facts and circumstances of its investigation of
Deering's allegations with anyone until the investigation was complete.
In 1997, AHCA concluded its investigation of the Deering allegations,
cleared me of any wrongdoing, and found "no probable cause" to proceed
with any disciplinary action.
I had been a member in good
standing of the Miami Children's Hospital medical staff from 1979,
where I staffed the hand clinic and where nearly all my surgery was pro
bono. When my 1996 application for reappointment was denied, I
requested a Fair Hearing. At the November 1996 hearing, I showed the
hearing committee a copy of AHCA's confidentiality agreement that
prohibited me from discussing the events related to my departure from
Deering Hospital. The hearing committee recommended that my
reappointment be "deferred" until the AHCA investigation was completed.
However, the Miami Children's Hospital Board of Directors ignored the
fair hearing committee's recommendation and dismissed me from the staff
in November 1996 several months before AHCA concluded its
investigation. Sadly, in 1996, Miami Children's Hospital had no
appellate review mechanism whereby I could have provided the results of
the AHCA investigation that had cleared me.
In addition to
dismissing me from its staff, Miami Children's Hospital reported my
dismissal to AHCA and to the National Practitioners Databank. Since
1996, I have had to explain these facts to the medical staffs of my
other hospitals during their biannual reappointment processes.
Fortunately, my local peers were intimately familiar with the political
and economic forces that governed decisions at Deering Hospital and
Miami Children's Hospital. Not only did none of the other hospitals
ever take any action against my medical staff membership, but also when
my membership was due for reappointment at Aventura, Baptist and South
Miami Hospitals, I was promoted through the ranks from provisional to
courtesy to active staff membership. It was abundantly clear to my
local hospitals, medical staffs that the actions reported to AHCA and
the Databank were not based upon any ethical, patient safety, or
quality of care issues.
In December 2002, over six years after
Miami Children's Hospital dismissed me, the Board of Medicine met to
decide my case. Although the Vice Chairman of the Board who was from
Miami and knew me professionally stated:
"This is a very reputable
physician, and an excellent physician I've known for many years, too,
as well, based on his character, functions and service to the
community. So I don't think that we're serving the best purpose, just
to keep a reprimand letter on him, and I would definitely speak-a
friendly amendment. If it would be okay, just to remove the reprimand.
I think it makes sense."
The Board, by a narrow margin, voted to
fine and reprimand me, rather than issue a nondisciplinary letter of
concern. The Florida Board of Medicine never contemplated suspending,
revoking, or placing probationary conditions on my license.
In
the early 1980s, my licenses in New York, Connecticut, and Maryland
became inactive because I no longer renewed them. However, after the
Florida Board voted to fine and reprimand me as a result of my
dismissal from Miami Children's Hospital, the New York State Department
of Health required that I pay $600 to reactivate my license and offered
me the opportunity to plead no contest to having been reprimanded by
Florida. Not only did New York fine me $1000, but also, in addition to
reprimanding me as had Florida, it censured me. (Apparently, unlike
Florida, New York's minimum penalty is both reprimand and censure). The
New York Department of Health, never contemplated suspending, revoking,
or placing probationary conditions on my license.
I believe that
in 1996 Miami Children's Hospital's actions against me were
economically motivated because I did not have any malpractice insurance
at the time. Despite the fact that I have not been sued or even
threatened with a lawsuit since 1984, Miami Children's Hospital, as a
matter of policy, was purging itself of all practitioners who lacked
medical malpractice insurance, because it did not want to be the "deep
pocket" for any malpractice actions by being tied to any physician who
was "bare". To this day, Miami Children's Hospital is the only
"not-for-profit" hospital in Miami-Dade County that requires its staff
members to have medical malpractice insurance. Why do I believe that I
was dismissed for lack of malpractice insurance? Because in 2004, after
having been fined and reprimanded by the State of Florida, reprimanded
fined and censured by the State of New York, I reapplied for medical
staff membership at Miami Children's Hospital. I was granted
provisional staff membership with all the privileges that I had
requested. Besides the actions against my licenses in 2002 and 2003,
what had changed between 1996 when I had been dismissed and 2004 when I
was readmitted to staff membership? The answer is that in 2004 I had
malpractice insurance.
In summary, this has been a Kafkaesque
nightmare triggered by events that occurred almost a decade ago. In
1995, I left the Deering Hospital because I believe that it was an
unsafe institution rife with activities by Columbia/HCA that were
unethical, if not illegal. I was proved correct when the federal
government fined Columbia/HCA over $1 billion and forced it to sell
Deering Hospital as part of a global settlement of Medicare fraud.
(Deering was the only Columbia/HCA hospital, whose sale was mandated by
the federal government as part of the global settlement.) Deering's
administration had falsely accused me of substandard patient care in
1995, and I was cleared by a confidential state investigation in 1997.
Miami Children's Hospital fair hearing committee recommended that my
reappointment application be deferred until the state investigation was
complete, but rather than wait, the Hospital terminated my privileges
and reported me to the state in 1996. Because of my dismissal from
Miami Children's Hospital, Florida fined and reprimanded me in 2002. In
2003, despite my never having either trained or practiced in New
York,and having an inactive license for over 20 years, New York forced
me to reactivate my license, fined, reprimanded and censured me.
Finally, in 2004 Miami Children's Hospital, whose dismissal of me
resulted in my being fined, reprimanded and censured, reappointed me to
its medical staff. Fortunately, my license has never been restricted
and the other local hospital staffs to which I belong realize that I am
a safe and ethical physician and not only kept me on their staffs, but
promoted me in rank at the appropriate time.
If you require any further information, please feel free to contact me.
Sincerely yours,
M. Felix Freshwater, M.D.
March 14, 2005
Dear Dr. Freshwater:
Your letter dated March 3, 2005 was received in the Board Office on March 7, 2005.
Thank
you for your prompt response to the Board's inquiry regarding
reprimands from the Florida Board of Medicine and the New York
Department of Health.
Your response is candid, detailed and
complete and is sufficient to close the matter. We shall update your
file to reflect your response.
Very truly yours,
R. Barrett Noone, M.D.
Executive Director
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