A national database of doctor discipline goes largely unused
Jim Guillaume blames the 2013 death of his wife on a surgeon’s incompetence. But without an expert witness to back him up, he long ago abandoned hopes of filing a lawsuit.
“I never could find a doctor who would testify,” he said. “They all hang together.”
Now six years after Susan Guillaume’s death from a massive infection, her husband of 46 years was surprised to learn from a reporter that Missouri officials agree urologist Christel Wambi-Kiesse was out of his depth in the operating room.
Missouri’s Board of Registration for the Healing Arts recently began seeking disciplinary action against the physician, who the board says was ill-equipped to perform minimally invasive surgical procedures while practicing at an Independence hospital in 2012 and 2013.
Wambi-Kiesse, the board said, “repeatedly performed robot-assisted surgeries far outside of his abilities resulting in operations three times longer than a member of Respondent’s profession would take under the same circumstances.”
The lengthy surgeries resulted in dangerous complications for his patients, the board said.
The complaint does not spell out the discipline it’s seeking, but Wambi-Kiesse — who is 44 and has a home in Overland Park — could potentially lose his medical license.
Reached Thursday by phone, Wambi-Kiesse had no comment, but did confirm that he is now seeing patients at the Department of Veteran Affairs hospital in Wichita. A department spokesman refused to discuss why the VA hired him when his name was on the National Practitioner Data Bank, which lists doctors who, according to the government’s General Accountability Office, “may have a record of misconduct or substandard care.”
Earlier this year, the GAO faulted the VA for not being consistent in checking the credentials of the doctors and other health professionals it hires. In some cases, VA officials overlooked or were unaware that a doctor was on the data bank’s list. However, presence on that list does not automatically disqualify a doctor from being hired by the VA, the GAO report said.
A spokeswoman for the Missouri Board of Registration for the Healing Arts declined to answer questions about the allegations in the complaint against Wambi-Kiesse or explain why it was filed so long after the alleged incidents of malpractice.
“We are unable to provide you with any additional specific case information on cases which are currently in litigation,” Lori Croy said in an email. It’s against Missouri law to go beyond what’s in the public record, she explained.
But if last year’s disciplinary actions are any guide, this is one of those rare cases where a doctor’s alleged errors in the operating room could rise to the level of official sanction in Missouri.
To support its case, the board cited three surgeries that Wambi-Kiesse allegedly botched in 2013 when he worked at the now-defunct Jackson County Urology clinic in Blue Springs, which was affiliated with Centerpoint Medical Center in Independence.
According to the board, Wambi-Kiesse performed two prostate surgeries two days apart in March 2013 that were overly long and resulted in both men suffering serious complications that could have killed them.
Neither operation should have taken more than four hours, said the complaint, which was filed in May and later amended. Instead, one lasted 14 hours and the other 12 and a half hours.
During the latter surgery, the complaint says, Wambi-Kiesse accidentally poked a hole into a 71-year-old man’s bladder while removing some of his enlarged prostate. Yet no one noticed until two days later — after the man went into renal failure — that his abdomen was filling with urine, causing a life-threatening infection.
As a result of his bladder being “nicked,” he spent three weeks recovering in the hospital, according to the lawsuit the man and his wife filed against the doctor, Jackson County Urology and Centerpoint. The case ended with a settlement. The man and his attorney declined comment due to that settlement’s confidentiality agreement.
The other man, 68, suffered multi-organ failure, sepsis and a long list of other complications when Wambi-Kiesse attempted to remove his cancerous prostate using robotic surgical procedures. The board faulted the doctor for continuing with the minimally invasive method even after learning that the prostate was twice as large as originally estimated.
“Respondent’s duration, performance, and judgment (patient selection and operative approach) failed to use the degree of skill and learning ordinarily used under the same or similar circumstances by members of his profession and caused injury,” the healing arts board said.
There is no record in state or federal court files indicating that the man filed a lawsuit. He did not respond to requests for comment.
Susan Guillaume was the third patient whose operation formed a basis for the complaint. While attempting to remove a tumor on her bladder, it says, Wambi-Kiesse accidentally perforated the organ, but failed to realize that until the operation was over. He never went back in to close the wounds, said Guillaume, who lives in Independence.
“My wife went in for a bladder biopsy,” he remembered. “He poked two holes in her bladder, and then he said ‘we’re just going to let it heal naturally.’ Two months to the day after she had that biopsy, she died from four major infections. … Heal naturally? All that poison went into her abdominal cavity.”
The complaint says Wambi-Kiesse also treated her with the wrong kind of chemotherapy.
Those three surgeries were not isolated instances. One document in the case file marked “Exhibit A” names another female patient who died on the day Wambi-Kiesse operated on her. But the document does not offer any specifics, and The Star was unable to reach family members for an explanation.
The three patients cited in the complaint were not named to protect their privacy. But like the other woman who died, the name of Susan Guillaume and the names of the two men who had the prostate surgery were printed in Exhibit A along with their dates of birth, Social Security numbers and dates of their operations.
That information was not intended to be public, but for some reason was not redacted in the case file maintained by the state’s Administrative Hearing Commission, which will decide the case. The Star is only identifying Susan Guillaume because her husband wished to speak publicly.
BEHIND OUR REPORTING
How did The Star learn about this story?
Reporter Mike Hendricks often checks Missouri’s Administrative Hearing Commission website, which lists litigation between Missouri state agencies and the public. That’s how he stumbled upon the Kansas City Chiefs’ tax returns. Two weeks ago he saw where the agency that regulates doctors is accusing a Kansas City-area physician of malpractice. The case looked interesting, so he followed up. (For more, click the arrow at top right.)
How did the reporter do his research?
Hendricks did an expansive Internet search to learn what he could about the doctor’s background and employment history, the medical procedures at issue and how many other doctors have been disciplined for alleged incompetence. From public documents and court records he learned the names of patients whose surgeries called into question the doctor’s abilities and sought to contact them or their survivors. He researched hiring practices at the Veterans Affairs hospital where the doctor now works. He also spoke with the doctor and traded emails with his attorney.
What happens next?
The Missouri Administrative Hearing Commission will consider the state’s medical licensing board’s contention that the doctor should be disciplined for substandard care of patients. If the commission agrees, it will then decide on the appropriate punishment. The doctor has a right to appeal.
Years before the board initiated action, a review panel at Centerpoint Medical Center raised concerns about 14 of the 160 surgical procedures Wambi-Kiesse performed there between mid-2012 and May 2013, when the panel issued its internal report. That report wasn’t public.
Also during the interim, Wambi-Kiesse, Centerpoint and Jackson County Urology settled another malpractice lawsuit in which a woman alleged improper care for one of her kidneys, which was later removed by another doctor after Wambi-Kiesse performed three surgeries on it.
Six years is a long time, but it’s not unusual for a case like this to slowly wend its way through the healing arts board’s disciplinary process, said Wambi-Kiesse’s attorney, Johnny Richardson.
“The Board has utilized different attorneys in the last several years,” he said via email. “That may have resulted in the delay.”
He declined comment on the specific allegations, stressing that the “allegations are just that, allegations.”
What is somewhat unusual is for physicians to be disciplined for incompetence. On its website, the board posts the names and penalties it has levied against the health professionals it has disciplined since at least late 2000. The Star reviewed the data and found that in 2018, 41 physicians — medical doctors and doctors of osteopathy — were sanctioned. The penalties ranged from reprimands for a doctor failing to complete required continuing education classes, to suspensions for failing to pay taxes, to revocation for egregious behavior.
The board revoked the licenses of six physicians in 2018, four others resigned in lieu of discipline and three surrendered their licenses voluntarily. Of those 13 cases, just two doctors lost their licenses for botched surgical procedures. The others lost or gave up their licenses for the most part because they either had been convicted of a crime, had been caught having sex with patients or had issues with substance abuse.
Records show Wambi-Kiesse graduated from the medical school at Northwestern University in 2003 and went on to do his residency in Texas, then earned fellowships at hospitals in Detroit and New York City.
He got a Connecticut medical license in 2011 and one from Missouri in 2012. Unless they are renewed, both are set to expire early next year.
During its investigation in 2013, after Susan Guillaume’s death, Centerpoint proposed that Wambi-Kiesse get an additional year of formal training in urology and robotic surgery.
He suggested instead that another physician could watch over him during 10 robotic surgeries to make sure he had sufficient skill.
The hospital denied his request.
VA hires him
Wambi-Kiesse resigned at the end of April 2014 and went on to a job at the Robert J. Dole VA Medical Center in Wichita, which recognizes medical licenses from all 50 states.
It’s unclear whether the VA hired him before or after Wambi-Kiesse’s name was added to the National Practitioner Data Bank, which flags doctors who have lost clinical privileges at a hospital, paid malpractice claims or been convicted of a health-related crime, among other concerns.
The data bank describes itself as “a workforce tool that prevents practitioners from moving state to state without disclosure or discovery of previous damaging performance.”
According to the healing arts board complaint, Centerpoint received notice from the data bank on April 11, 2014, two weeks after Wambi-Kiesse tendered his resignation. A VA spokesman refused to say when Wambi-Kiesse was hired or even whether he still works there. Wambi-Kiesse said in the phone call with The Star that he was currently employed at the VA.
A GAO report issued in February criticized the department for not always checking the data bank when making hires. Screeners in at least five hospitals were unaware of the law and VA policy that bars employing doctors and nurses whose licenses had been revoked or surrendered for professional misconduct or incompetence, unless the license has been reinstated.
Pay records on the website www.fedsdatacenter.com show Wambi-Kiesse made $300,000 or more annually as a physician at the VA in Wichita from 2015 to part of 2018. Information from prior years was not available.
Jim Guillaume was surprised to learn that Wambi-Kiesse was still a doctor. Having served in the Navy during the Vietnam era, it upset him to think that the doctor who operated on his wife is now taking care of fellow veterans and their families several hours down highway from his home.
“I’ll stay away from that VA hospital where he’s at, I’ll guarantee you,” Guillaume said.