Blind Eye: The Terrifying Story of a Doctor Who Got Away With Murder (23 page)

Despite his past, Swango had a semblance of a normal, stable life, with a well-paid job and a wife. Yet almost immediately after
the wedding, problems surfaced. His relationship with Rita, which had survived so many external strains, rapidly deteriorated. She later confided that she realized almost immediately after marrying Swango that she had made a terrible mistake. Despite his years of purported devotion, he now showed scant interest—either romantic or sexual—in her. He wouldn’t sleep in the same bed, and lived almost entirely in one room of the apartment, its den. He was constantly working on his computer and ignored Rita. She also complained that he stole money from her account and refused to contribute any of his earnings toward household expenses. But the breaking point may have come when a clerk at a nearby video rental shop became pregnant. Rita was certain that Michael was the father. In any event, she thought he had been cheating on her with other women. In January 1991, only a year and a half after marrying, Rita and Swango separated, later stating in court that they intended to “discontinue permanently the marital cohabitation.” Rita resumed use of her maiden name, Brodegard.

As Swango’s marriage unraveled, some Aticoal employees became violently ill. Banks himself had to be hospitalized after suddenly feeling dizzy, nauseated, weak, and sweaty. Another executive lapsed into a near coma after experiencing similar symptoms, and also had to be hospitalized.

Meanwhile, Swango resumed his quest for employment as a doctor. By early May 1991, Swango, or Adams, as he now legally was named, was in contact with doctors at Ohio Valley Medical Center in Wheeling, West Virginia, about a job opening there. He had to reveal his real name so it would accord with his medical school record and references; the hospital’s chief of medicine, Dr. Jeffrey S. Schultz, later told the Illinois police that Swango claimed that his Illinois medical license had been suspended on account of a “single felony/battery conviction resulting from an altercation occurring in a restaurant.”

At the time there was no national clearinghouse for information about doctors convicted of crimes or found liable for malpractice. The American Medical Association kept a “master file” intended to track errant doctors, and the American Federation of State Medical Associations maintained a list of doctors whose licenses had been suspended by state boards. But neither had any details
of Swango’s arrest and conviction. In any event, there’s no indication Dr. Schultz made any attempt to contact them. Instead he wrote the state’s attorney’s office in Quincy, saying that “we are considering offering him a position” and “we want to be fair to this young man.” The letter continued, “Frankly, the severity of his punishment seems out of proportion to the offense committed, based on his description.”

Dr. Schultz also checked with the Illinois Department of Professional Regulation, the body that had suspended Swango’s license, and learned that he had not, in fact, been convicted of battery because of any “altercation” in a restaurant, but had been convicted of six counts of poisoning. Dr. Schultz confirmed this in a phone conversation with the state’s attorney in Quincy.

It is apparently a measure of Swango’s persuasiveness, not to mention one doctor’s evident willingness to take the word of another, that the revelations from Illinois did not bring negotiations between Ohio Valley and Swango to a halt. Schultz wrote Swango a letter offering him the opportunity to document his version of events. Swango responded in a letter dated May 20:

Dear Dr. Schultz,

I received your letter of 5-10-91 on Thursday, May 16, and I’ve been working constantly since then to try to locate and obtain, as soon as possible, the copies you requested . . . . I’m so happy to tell you that via numerous phone calls and FedEx, I’ve been able to get copies of what you need, I’ve enclosed three sets of copies, so people can have them right away . . . . As we discussed during my interview, I’m prepared to accept a position right away—and am truly looking forward to coming to Wheeling and joining your Residency program.

Thanks again.

Sincerely,

David J. Adams, M.D.

Among the documents Swango provided was a prison discharge “fact sheet,” which explained the battery as a brawl. “Releasee struck a blow with his fist,” the document said. Similarly, a “docketing statement” contained this description of the case:

Appellant was convicted in a bench trial of (felony) battery, violation of Chapter 38, Illinois Revised Statutes, Section 12-4—intentional application of physical force to an individual with resultant bodily injury caused by said force. In this case, the force was a blow struck by appellant’s fist.

Appellant was sentenced to a term of six months, to be followed by eighteen months probation . . . .

Swango also submitted a 1989 letter from the governor of Virginia, Gerald L. Baliles. Written on the letterhead of the Commonwealth of Virginia, Office of the Governor, it said,

Dear Mr. Swango:

I have before me your application for Restoration of Civil Rights which will restore certain rights forfeited as a result of your felony record.

Reputable citizens who are familiar with your conduct since your conviction(s) advise me that you are leading an upright, law-abiding life and they recommend that your civil rights be restored. Relying on these recommendations, I am removing your political disabilities . . . .

I am pleased to convey my actions to you and wish you much success in the future.

These and other documents prompted Dr. Schultz to write again to Quincy authorities, this time saying that Swango had “submitted copies of court documents which would appear to support his story.” Schultz asked for “a brief letter” indicating “the nature of his difficulties which led to his revocation of his medical license.” He attached copies of the documents Swango had submitted.

Quincy authorities were both alarmed and amazed. The docketing statement was an outright forgery—a crime in itself. (The state of Virginia verifies that Swango’s civil rights were indeed restored, on December 31, 1989.)

Scott Walden, the Adams County state’s attorney, immediately sent Schultz copies of Swango’s sentencing order and of the appellate court opinion rejecting his appeal. He also sent copies of the materials to Judge Cashman, urging that he, too, contact Schultz. In his note to Cashman, Walden wrote, “As you can see, Swango has
gone to great lengths to cover up what he has done—even to the point of falsifying documents.”

The flurry of documents and calls from Quincy finally persuaded Schultz to reject Swango’s application. But there’s nothing to suggest that doctors at Ohio Valley took any further steps to alert other doctors and medical residency programs to the possibility that Swango might apply. In any event, the rejection did nothing to discourage Swango, who was soon applying for other resident positions.

I
N
1986, while Swango was still serving his prison term in Centralia, Dr. Michael Prince Brody was suspended from practice at John F. Kennedy Memorial Hospital in Indio, California, after an anonymous caller alleged that Dr. Brody had submitted false references and concealed his past. When the hospital investigated, it learned that five years earlier, Dr. Brody had been suspended by Bayshore Hospital in Pasadena, Texas, where he was a staff obstetrician, after a series of bizarre incidents that culminated in his being admitted to the emergency room with a stab wound. Brody claimed to have operated on his own abdomen with a pocket knife.

Dr. Brody had been suffering a drug problem for years. Nurses reported that he took Dexedrine by day and Valium at night, and had actually fallen asleep while performing surgery on a patient. They often had trouble locating him, and he frequently refused to see patients. Long before the stabbing incident, Bayshore Hospital administrators had concluded that he “personally abused analgesic, sedative and stimulant drugs, including amphetamine compounds, benzodiazepine compounds and opiate compounds,” according to a later report. Before being hospitalized for drug treatment, Brody “had been regularly seeing patients, treating patients, and making decisions with regard to the welfare of patients while suffering from an adjustment disorder with mixed disturbance of emotion and conduct, mixed substance abuse, and psychological factors affecting physical conditions,” the report continued.

In 1980 Brody did not respond to an urgent summons to show up for the delivery of a baby girl. Nor had he arranged for another doctor to cover him in his absence. The infant, Andrea Ferris, suffered brain damage from loss of oxygen and was subsequently
awarded $119 million in an out-of-court malpractice settlement, at the time the largest ever awarded in Texas. Brady’s hospital privileges at Bayshore were suspended. But after he agreed to undergo psychotherapy and substance abuse treatment, they were reinstated.

A month later came the episode in which Brody said he had operated on himself with a pocket knife. His hospital privileges at Bayshore were now revoked, this time for good.

But this was hardly the end of Dr. Brody’s medical career. No one at Bayshore reported him to state medical authorities, to the American Medical Association, to the Federation of State Medical Boards, or to any other investigative authority. Brody moved on to Hospital in the Pines, in Lone Star, Texas, where he again failed to respond to calls to deliver a baby. This time both mother and child died. The hospital reached an undisclosed settlement with surviving family members, and Dr. Brody resigned. Again, no other disciplinary action was taken.

When Dr. Brody applied to renew his Texas medical license in 1982, he responded no when asked whether he had ever been disciplined by a hospital, even though Bayshore had revoked his privileges. His license was renewed. Brody left Texas, was licensed in California, and was hired at JFK Memorial in Indio. His license to practice in Texas was still in effect when JFK suspended him.

Brody’s is hardly an isolated case. This and other examples of doctors moving from state to state to escape disciplinary action and license suspension were the focus of a June 23, 1986, episode of ABC’s
Nightline.
Asked on the show why he hadn’t reported Dr. Brody, a spokesman for Bayshore Hospital said simply, “It’s, I don’t think, up to me to report these kinds of things to the state board of medicine.”

The medical literature, not to mention the popular press, has been full of accounts of incompetent physicians. In 1986,
The New York Times
quoted medical officials to the effect that “five out of every 100 doctors are so incompetent, drunk, senile or otherwise impaired that they should not be practicing medicine without some form of restriction.” A medical director of the Kaiser Foundation Health Plan testified in Congress in 1986 that 3 to 5 percent of the nation’s 425,000 practicing physicians have an “impairment of some degree from a wide variety of causes.”

Even when hospitals or state licensing boards take action against incompetent doctors, they usually do so quietly, often in confidence, as they did with Swango. The result, concluded Robert Adler, counsel to the U.S. House of Representatives Subcommittee on Health and the Environment, charged with regulating the medical profession, is “a group of ‘rogue’ physicians who are free to leave the immediate hospital or jurisdiction and continue their practice elsewhere.”

While
Nightline
brought the Brody case to the attention of a national audience, and eventually to that of lawmakers in Washington, the problem of “rogue” doctors would no doubt have gone un-addressed had the medical community itself not reacted as strongly as it did to an Oregon case. In 1981, several of Dr. Timothy Patrick’s colleagues at Columbia Memorial Hospital in Astoria, Oregon, alleged that he was incompetent and recommended that his hospital privileges be suspended. These same doctors had earlier invited the surgeon to join them in their practice at a local clinic. Instead Patrick started a competing practice of his own. After they tried to revoke his hospital privileges, Patrick sued the doctors, claiming they were trying to maintain a monopoly by shutting down his practice. A federal district court jury agreed with Dr. Patrick, and awarded him $650,000, which under federal antitrust laws, was trebled to nearly $2 million in damages.

The result outraged the medical profession, and not because Dr. Patrick had been mistreated by his fellow physicians. Many doctors felt the verdict threatened the peer review process. As they saw it, doctors who tried to discipline a colleague for incompetence had instead been punished themselves.

Peer review, the evaluation of practicing physicians by other physicians, is the foundation of the disciplinary process within the medical profession, and has been at least since 1760, when doctors were first licensed in the United States. The notion is that only doctors can evaluate the quality of patient care, a principle that the American Medical Association has championed with near-religious zeal. This deeply ingrained tradition was no doubt part of the reason that Ohio State doctors resisted calling the police to investigate Swango, and they openly acknowledged their fears of being sued.

In the wake of the Patrick verdict, doctors argued vociferously that his case and several similar ones were making it all but financially
ruinous for doctors to try to dismiss an incompetent physician. When the Patrick case went to the U.S. Supreme Court, the AMA argued that “doctors who seek to discipline other doctors they consider incompetent should not be put at risk of huge damage awards for which insurance is not available, whenever a jury can be convinced their motives were not pure,” according to
The New York Times.
And the AMA lobbied for federal legislation exempting doctors from the nation’s antitrust laws, to eliminate the possibility that doctors could be sued for terminating another doctor’s privileges or suspending a license.

But the AMA’s sudden interest in strengthening the peer review process by insulating doctors from liability struck many as disingenuous, for the profession’s efforts to police itself had always been lax. While the logic of peer review has never been seriously questioned, its effectiveness has. In a 1988 study, Timothy Jost, a law professor at, of all places, Ohio State, concluded that “there is substantial evidence that, despite its potential, the medical staff [peer review] system has traditionally operated quite laxly.” It is “never a comfortable task to sit in judgment of one’s peers with whom one works on a day-to-day basis. A physician in this position must always deal with the temptation to give the benefit of the doubt and gloss over a colleague’s errors.”