Published 2/15/2022

AAOS Board Considers Grievance Filed under the Professional Compliance Program

At its meeting on Dec. 3, 2021, the Board of Directors of the American Association of Orthopaedic Surgeons (AAOS) considered a grievance filed under the AAOS Professional Compliance Program. The following action was taken:

Kimberly A. Les, MD
Columbiaville, Mich.
Six-month suspension

A grievance alleging violations of the Standards of Professionalism on Orthopaedic Expert Opinion and Testimony was filed against Kimberly A. Les, MD. The grievance was based on statements made by Dr. Les in an affidavit of meritorious claim and deposition testimony. The patient in the underlying case was a 46-year-old female with a history of right proximal humerus osteosarcoma resection done approximately nine years prior.

The patient presented in 2014 with complaints of diffuse pain in her shoulder and neck and shoulder instability. Radiographs showed a disassociation of the humerus to the glenoid with a separation of 4 to 5 inches. MRI showed atrophy of the musculature about the shoulder girdle and a large fluid mass but was negative for any osteosarcoma recurrence. The grievant met with the patient and her husband several times, at which time he described the issue and discussed different treatment alternatives. The grievant’s office notes reference several conversations and contained copies of pictures he used during those conversations. The patient also met with the vascular and plastic surgeons who would be involved in the operation. The patient underwent a glenohumeral fusion with a vascularized free fibular autograft.

Postoperatively, the patient had what appeared to be an impending compartment syndrome of her hand and went back to the operating room for a multicompartment fasciotomy. The patient was seen by the grievant for several months after the surgery. The grievant’s office notes stated that the patient’s incisions were healing and her hand function was almost normal, but she continued to have some dysesthetic hand pain. After the patient had stopped seeing the grievant, it was noted that the patient’s graft fractured, and she subsequently underwent additional surgeries. Under Dr. Les’s care, the patient underwent a revision of the fusion with an allograft placed. In addition to the revision, other procedures were done, the last being a custom humeral replacement.

After thorough consideration and deliberation, the Committee on Professionalism (COP) Grievance Hearing Panel and the Judiciary Committee found that Dr. Les’s expert testimony was in violation of Mandatory Standard No. 6. In her affidavit, Dr. Les stated that the grievant failed to take a thorough history, perform a physical exam, order tests, discuss risks, and obtain informed consent. In her deposition, she testified that she reviewed records that were provided by counsel and her own records, but she did not review the office records or imaging of the grievant prior to signing the affidavit. Mandatory Standard No. 6 states that an expert shall review all pertinent medical records before rendering a statement or opinion on the medical management of the patient. As such, the COP Grievance Hearing Panel was of the view that the grievant’s medical records were pertinent in this case and should have been sought and reviewed prior to the rendering of opinions on the care provided to the patient. The panel found Dr. Les’s testimony to be contradictory to the medical records and in violation of Mandatory Standard No. 6.

The Judiciary Committee unanimously affirmed the COP Grievance Hearing Panel’s findings and also found Dr. Les’s statements concerning because they were made without a review of all of the pertinent records, and because taking the patient’s medical history, performing an examination, and undergoing informed-consent discussions would have been required before a patient could undergo such a surgical procedure. Had she reviewed the grievant’s records, the Judiciary Committee believes, Dr. Les would have noted that the medical records were thorough in detailing the diagnostic tests, patient physical and history, and multiple discussions regarding risks and benefits of the procedure.

The AAOS Board of Directors upheld the findings of the Judiciary Committee and voted to suspend Dr. Les for a period of six months.

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