ST. LOUIS • Construction worker Curtis Wren came to Dr. Faisal Albanna in 1998 after injuring himself through heavy lifting. The St. Louis area neurosurgeon examined Wren and recommended a “bone fusion.” A hollow metal screw would be inserted into his spine to fuse the vertebrae.
Soon after the surgery, Wren complained of a burning sensation. Days later, he was admitted to the emergency room with severe lower back and leg pain. X-rays indicated that the bone was not fusing. A year later, Wren underwent corrective surgery by another doctor — and sued Albanna for medical malpractice.
Wren, it turned out, wasn’t the first patient to sue Albanna. And he wouldn’t be the last.
In recent years, Albanna was a multimillion-dollar rainmaker at Des Peres Hospital — performing complex and risky surgeries on patients’ spines, necks and brains. Albanna’s precision was extolled by some of his former patients. He handled difficult cases, from blood clots to traumatic brain injuries. In one celebrated case in the late 1990s, he saved the life of a Jefferson County sheriff’s deputy who was shot in the forehead, carefully removing metal fragments from the man’s brain.
Albanna once compared repairing a ruptured brain aneurysm to “defusing a mine.”
But the neurosurgeon — and, in some cases, his firm, Cedar Village-based Albanna Neurosurgical Consultants P.C. — also was a defendant in about 50 lawsuits alleging negligence since 1987, including four wrongful death cases, court records show.
Albanna, of Town and Country, was able to continue practicing medicine even after the state’s highest court upheld key findings by the Missouri medical board against him.
While the medical board, a state commission, and appellate courts undertook a decade-long review of Albanna’s professional conduct, dozens of patients filed lawsuits against him, saying that the neurosurgeon’s negligence left them with permanent nerve damage, chronic pain and lost income. When placed on probation in 2010, Albanna hung on to his medical license and continued to perform surgeries.
Missouri’s medical board and court system tend to move cautiously in cases of alleged misconduct by doctors. Albanna’s defenders say that he was slowly driven out of business, while others maintain that state regulators, hospitals and insurers were far too lenient.
“I think he’s hurt a lot of people,” said Alvin Wolff Jr., a lawyer from Clayton who filed a suit last year on behalf of Gary Cotter of Pinckneyville, Ill., that accused Albanna of performing an unnecessary surgery on his spine in 2010 that left him in permanent pain and hunched over. “Why do the hospitals let a guy like this on staff? Why do they let a guy like this stay on staff?”
While the neurosurgeon drew complaints, he also won praise. Albanna saved the life of Jefferson County sheriff’s deputy Donald J. Cummines, who was comatose and near death when admitted in 1998 to Mercy Hospital St. Louis after taking a shotgun blast in the forehead. Albanna extracted metal fragments from Cummines’ brain, and later repaired a leak in his brain that was caused by a fragment. Although the deputy sheriff never fully recovered, he eventually took a job as the civilian director of Jefferson County Jail.
Still, some hospitals where Albanna performed surgeries also were drawn into litigation.
Tenet Healthcare Corp., the parent of Des Peres Hospital, has been sued repeatedly in recent years by patients for renewing Albanna’s credentials. The hospital denies any liability but has settled four of these lawsuits, including a case filed last spring by the parents of a young man who died under Albanna’s care.
Earlier in his career, Albanna worked as a neurosurgeon at other St. Louis area hospitals including St. Anthony’s Medical Center, SSM St. Mary’s Health Center, and Mercy Hospital St. Louis in Creve Coeur. He no longer has hospital staff privileges at Des Peres, but malpractice cases are still pending against him and the hospital.
Simone Valle, a Des Peres Hospital spokeswoman, declined to discuss pending litigation. She said that Albanna had been “an independent physician on our staff” since 2005 but had not performed any surgeries there since August 2011 when he took a leave of absence.
Albanna, 60, declined to comment. He recently told a court that he was “not currently practicing medicine.”
In February, he filed for Chapter 7 voluntary bankruptcy protection in U.S. Bankruptcy Court. He listed assets of $1.1 million, including a 3,813-square-foot home in a gated community. He listed liabilities of $1.7 million, including nearly $400,000 in legal fees and more than $350,000 in credit card debt. He described his occupation as a “disabled neurosurgeon,” stating that he receives $21,000 a month in disability insurance benefits.
In an Internet ad, he introduces himself as a consultant for Innovo LLC, which has a post office box address in Kimmswick, Mo. His services include research and development of neurosurgical products and expert witness testimony in court cases.
A 2011 study in the New England Journal of Medicine found that nearly all physicians in high-risk specialties such as neurosurgery face at least one malpractice claim in their careers. Last year, Albanna was sued four times.
“He became, for lack of a better term, a target,” said Thaddeus Eckenrode, a defense lawyer from Clayton who represented Albanna in more than a dozen cases. “Plaintiffs’ attorneys found him to be an easy mark.
“To the outside world, it would look very unusual that a doctor was sued so many times,” he said, “but my perception is that only a small percentage of his cases were being settled, and a large percentage were frivolous.”
Eckenrode emphasized that the neurosurgeon accepted high-risk cases that other doctors were unwilling to touch, including patients with serious injuries, chronic conditions and failed treatments.
“Part of Dr. Albanna’s problem is that he took on cases that other doctors had passed on,” Eckenrode said, “and he saved people from significant neurological issues. He wanted to save everyone.”
Plaintiffs’ attorneys tell a different story.
“I’ve been doing medical negligence work in St. Louis for 26 or 27 years, and I’ve never seen as many cases filed against one person,” said Jim Leonard, a lawyer from St. Louis who brought two cases, including the Wren case, against Albanna.
Wren, of High Ridge, was 38 at the time of his injury. But after his surgeries, he could not return to work. A jury found in his favor, but ultimately the case was settled for an undisclosed sum.
Now, at 54, Wren says that he still suffers from back pain. He laments his forced retirement and wishes that he could play basketball with his grandchildren.
“I guess the medical board didn’t do their job,” he said. “They let it go. ... They should have got him out of there.”
PROBATION AND APPEALS
Albanna was born in Baghdad, Iraq, and received his medical degree in Vienna, Austria. He obtained additional training in the United States and is board certified in neurosurgery in Missouri.
In the late 1990s, the Missouri State Board of Registration for the Healing Arts began investigating Albanna. In 2003, the board sanctioned him for “unprofessional conduct” and “repeated negligence” in six cases. A state commission affirmed the board’s findings in two cases, and the board placed Albanna on probation for five years. But his attorneys appealed. Albanna claimed that no other licensee had been punished so severely and that the discipline was “discriminatory” because “he has been treated differently and more harshly due to his nationality.”
In 2009, the Missouri Supreme Court upheld the medical board’s finding that Albanna had engaged in unprofessional practice, “which is or might be harmful or dangerous to the mental or physical health of a patient or the public.” The court found that there had been no need for him to perform the bone fusion surgery on Wren 11 years earlier, and that a simpler procedure should have been done. But the court did not find Albanna incompetent — and sent the case back to the appellate court to review the probation order.
In January 2010, Albanna agreed in a settlement with the medical board to be “publicly reprimanded for performing more extensive than warranted surgeries” on two patients, including an unnamed woman in 1996, and to be placed on probation for four years. He also agreed to fill out an “informed consent” form for each patient he treated; to submit all of his peer review reports to the medical board each quarter; and to report to the board all serious complications from his surgeries.
Illinois and Pennsylvania regulators took similar action, placing Albanna on probation for four years.
Mark Schoon, a lawyer from University City who represents Albanna, stressed that in 2011 the doctor successfully appealed a separate disciplinary case by the Missouri medical board. In that case, the board found negligence in Albanna’s care of six additional patients, two of whom died under his care. But the state Administrative Hearing Commission found no cause to discipline Albanna.
“We have not found that Albanna committed acts that would constitute repeated negligence,” wrote Commissioner Nimrod T. Chapel Jr. “We found no instances of inappropriate or unnecessary surgeries recommended or performed by Albanna.”
HOSPITAL RENEWS PRIVILEGES
Albanna was sued last year by the parents of a 23-year-old man who died in his care. The lawsuit, lodged in the Circuit Court of St. Louis County on behalf of Robert Danieli, also accused Des Peres Hospital of failing to properly review Albanna’s credentials and allowing the neurosurgeon to operate “without limitation or supervision” — and without medical malpractice insurance for brain surgery.
“Albanna was a bad doctor who continued to hurt his patients,” the suit alleged, “but nevertheless defendant hospital put patients in harm’s way.”
Danieli died May 9, 2009, of extreme swelling and pressure in his brain — the day after Albanna performed surgery to remove a shunt, or tube, from his brain that was causing an infection. Danieli had been hydrocephalic (with excessive water on his brain) since birth, and he lacked sight in one eye.
Two neurosurgeons concluded that surgery on Danieli would be too risky, but Albanna was willing to operate. Seven doctors later filed sworn affidavits in the Danieli case, saying that Albanna’s conduct fell below the standard of care.
According to the Danielis’ complaint, Albanna generated on average about $12 million a year in gross revenue for Des Peres Hospital and he was the only neurosurgeon with staff privileges at the hospital.
“That’s a lot of money. He’s virtually unique,” said Burton Greenberg, a lawyer from St. Louis who represents the Danielis. Greenberg said that in 53 years of law practice, he had never encountered a physician who had been sued as many times as Albanna.
“I don’t have the ability to put a doctor out of business,” Greenberg said. “It’s for the Legislature to pass more stringent legislation, I suppose.”
Typically, hospital peer review panels make decisions to grant staff privileges to a doctor. Such decisions occasionally draw fire. Appellate courts in various states have upheld judgments against hospitals for poor credentialing, including failing to investigate the high numbers of lawsuits against a physician.
Des Peres Hospital’s former chief executive, Michele Meyer, served in that role from 2000 through her abrupt departure for undisclosed reasons in mid-February 2011. During her tenure, Albanna’s staff privileges were first approved in 2005 and renewed in subsequent years.
Tenet executives had access to the National Practitioner Data Bank, the federal database that tracks the settlements paid in medical malpractice lawsuits filed against physicians and the adverse decisions by state licensing boards.
The confidential registry was established in 1990 to enable health care executives to investigate the qualifications of physicians. Federal law requires each hospital to query the database before hiring or first granting staff privileges to a physician — and to query the records of all of its affiliated physicians at least once every two years.
Meyer, who is currently vice president of operations at Mercy Hospital Jefferson, declined to comment about Albanna and her role in Des Peres Hospital’s decisions to grant staff privileges to him.
In court papers, Tenet argued that the hospital acted in good faith — and that Albanna’s privileges were last renewed in June 2010.
“Des Peres Hospital, in granting surgical privileges, does so through its governing board,” Tenet lawyers said in court papers, “based on the recommendations of its credentialing committee, peer review committee and medical executive committee.”
But the Danielis charged that Des Peres circumvented its own procedures to grant Albanna staff privileges. The hospital “created a rump committee,” their suit alleged, “so as to bypass the credentialing process and thwart efforts by the normal chain of command whose function it was to investigate Faisal Albanna.”
It’s a potent allegation but unlikely to ever be proven. Tenet argued that Missouri law exempts its peer review deliberations and performance improvement files from discovery in a civil lawsuit. And the Danielis’ case against Tenet was settled last fall for a confidential sum before a judge could rule on that issue.