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AAOS Now

Published 9/1/2020

AAOS Board Considers Grievances Filed Under the Professional Compliance Program

At its meeting on June 4, 2020, the Board of Directors of the American Association of Orthopaedic Surgeons (AAOS) considered three grievances filed under the AAOS Professional Compliance Program. The following actions were taken:

Richard A. Matza, MD
Waterbury, Conn.
Expelled

In August 2018, a grievance alleging violations of the Standards of Professionalism (SOP) on Orthopaedic Expert Opinion and Testimony was filed against Richard A. Matza, MD. The grievance was based on statements made by Dr. Matza in his deposition testimony and affidavit. The underlying matter involved a 46-year-old patient who underwent arthroscopic shoulder surgery to repair a small tear in her rotator cuff and then later sustained a stroke.

After thorough consideration, the Committee on Professionalism (COP) Grievance Hearing Panel and the Judiciary Committee found that Dr. Matza was in violation of Mandatory Standards Nos. 2, 3, 4, and 5. With regard to Standard No. 2, in both Panels’ opinions, Dr. Matza was not fair and impartial when he responded with varying degrees of confidence as to whether aspirin given postoperatively would have prevented the stroke, and when he initially alleged 20 acts of negligence, but later reduced the allegation to one claim of negligence concerning the use of aspirin postoperatively. With regard to Standard No. 3, both Panels found that Dr. Matza demonstrated a lack of knowledge of the standard of care at the time and in the context of the care delivered when Dr. Matza opined that the Grievant’s failure to administer aspirin six hours postoperatively was a breach of the standard of care. Dr. Matza provided no supporting literature, and the Panels believed that at the time of the patient’s surgery there was no generally held standard to administer aspirin postoperatively in upper extremity surgeries. With regard to Standard No. 4, the Panels found that Dr. Matza’s testimony condemned care that fell within generally accepted practice. And with regard to Standard No. 5, the Panels found that Dr. Matza was unable to support his opinion regarding postoperative use of aspirin, as he testified that he had not reviewed the literature, he was unaware of any published guidelines at the time, and, even in his own clinical experience, it would be rare to prescribe aspirin postoperatively.

Each Panel’s findings in connection with this matter were based on the facts and information presented in the specific grievance; however, they also considered what they believed to be a pattern of behavior that was inconsistent with the SOPs in recommending compliance action. In a prior grievance, the Board suspended Dr. Matza for one year as a result of expert testimony found in violation of four SOPs.

The AAOS Board of Directors upheld the findings of the Judiciary Committee and voted to expel Dr. Matza.

Eric G. Meinberg, MD
San Francisco
Censured

In 2018, a grievance alleging violations of the SOP on Orthopaedic Expert Opinion and Testimony was filed against Eric G. Meinberg, MD. The grievance was based on statements made by Dr. Meinberg in a declaration, deposition, and trial testimony. The patient in the underlying case was a 59-year-old woman who presented with left hip pain for over five years after an accident and underwent a left total hip replacement through a posterior approach. Postoperatively, the patient had a foot drop and numbness in the left foot and leg. Two years after the replacement, a scanogram report showed a discrepancy between the lower extremities of less than or equal to 1 cm. After thorough consideration and deliberation, the COP Grievance Hearing Panel and the Judiciary Committee found that Dr. Meinberg violated Standard No. 4 when he testified that a 2 cm discrepancy was the “widely accepted” standard of care, but then condemned the surgeon for overlengthening the patient’s leg 1.0 cm to 1.5 cm, which he testified was within the generally accepted practice standard. The COP Hearing Panel did not find Dr. Meinberg in violation of Standards Nos. 1, 2, 3, and 6.

The Judiciary Committee, however, also found Dr. Meinberg in violation of Standard No. 2. In the Judiciary Committee’s opinion, Dr. Meinberg’s testimony was not fair and impartial because his explanation of the standard for tolerable discrepancies varied each time he was asked. The Judiciary Committee agreed with the COP that Dr. Meinberg did not violate Mandatory Standards Nos. 1, 3, and 6.

The AAOS Board of Directors upheld the findings of the Judiciary Committee and voted to censure Dr. Meinberg.

James R. Ross, MD
Deerfield Beach, Fla.
Censured

In December 2018, a grievance alleging violations of the SOP on Orthopaedic Expert Opinion and Testimony was filed against James R. Ross, MD. The grievance was based on statements made by Dr. Ross in an affidavit and summary letters. The patient in the underlying case was a 40-year-old firefighter who suffered a complex labral tear with degeneration and underwent arthroscopic labral tear débridement, synovectomy, femoral head, and acetabular chondroplasty. At the completion of the procedure, imaging revealed a small metallic density present. The fragment was not found but was suspected to have migrated into a periacetabular bursa or sequestered in the periportal soft tissue. After care was transferred to Dr. Ross, CT imaging located the fragment within the posterior hip joint. Dr. Ross performed arthroscopic surgery to remove the foreign body and repair the labrum.

After thorough consideration and deliberation, the COP Grievance Hearing Panel and the Judiciary Committee found that Dr. Ross’ expert opinions were in violation of Mandatory Standards Nos. 2 and 9. With regard to Standard No. 2, in both Panels’ opinions, Dr. Ross was not fair and impartial in his determination that the metallic fragment was a substantial source of the development of the patient’s hip symptoms. The Panels were of the belief that Dr. Ross’ operative report lacked any descriptive language that would suggest the fragment caused the chondral injury, yet he became increasingly descriptive and critical with each opinion he provided to counsel.

Both Panels agreed that Dr. Ross’ statements on causation and standard of care established that he was acting as an expert and was therefore subject to the SOPs. Standard No. 9 requires AAOS members serving as an expert witness to maintain “a current certificate from the American Board of Orthopaedic Surgery.” Because Dr. Ross was an AAOS Candidate member at the time of his testimony and did not yet have a certificate, the Panels found Dr. Ross to be in violation of Standard No. 9. The Panels did not find Dr. Ross to be in violation of Mandatory Standards Nos. 1, 3, 6, and 11.

The AAOS Board of Directors upheld the findings of the Judiciary Committee and voted to censure Dr. Ross.

Additional actions not related to the AAOS SOPs

At its meeting on June 4, 2020, the AAOS Board of Directors considered matters not related to the AAOS SOPs and took the following actions:

Evangelos Megariotis, MD
Clifton, N.J.
AAOS Fellowship Suspended

In January 2019, the New Jersey State Board of Medical Examiners entered a supplemental order modifying conditions and limitations on practice in which Evangelos Megariotis, MD, is precluded from performing procedures and is prohibited from prescribing, dispensing, and administering all controlled substances. This action stemmed from allegations of improper prescribing of controlled substances and performance of surgery without medical justification.

The AAOS Board of Directors voted to suspend Dr. Megariotis’ Fellowship in AAOS until he holds a full and unrestricted license to practice medicine.

Cathleen Van Buskirk, MD
Lafayette, Colo.
Expelled

In March 2019, Cathleen Van Buskirk, MD, was convicted of one felony count of bankruptcy fraud for concealment of personal assets in a bankruptcy petition. She was sentenced and fined.

The AAOS Board of Directors voted to expel Dr. Van Buskirk.

For more information on the AAOS Professional Compliance Program, visit www.aaos.org/profcomp.