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Witnesses express doubt over misdeeds

The attorneys for Mid-Columbia Medical Center set out Tuesday to show how the sexual abuse complaints of surgery patients could reasonably be interpreted by medical personnel as drug-induced hallucinations.

Andrew Efaw, one of three attorneys on the hospital’s legal team, put Dr. John Butterworth IV on the stand Oct. 15 to testify about the side-effects of anesthesia. The research of the physician has been published in numerous peer reviewed journals — where subject matter has to be approved by others in the field — during a long career.

Butterworth resides in Richmond, Va., and was hired by MCMC to share information on a report he co-authored in 2007 with Dr. Robert Strickland. That work is titled “Sexual Dreaming during Anesthesia: Early Case Histories (1849–1888) of the Phenomenon.”

The doctor had been given the pre-trial testimony and medical records of the three plaintiffs in the case and a female patient who complained of molestation by Dr. Frederick Field, a former anesthesiologist, in 2008. Butterworth said one of three drugs commonly used in surgeries and known to cause sexual hallucinations had been used to sedate each of the women.

During his research, Butterworth said he had found similar accusations of molestation made by women against oral surgeons after they were sedated. He said the side effects of some drugs, such as Midazolam or a variation of another name, included loss of inhibitions, amorous behavior and abnormal dreams.

“Did you come across any incidence where the allegations of assault had a medically plausible explanation?” asked Efaw, to which Butterworth replied, “Yes.”

Gregory Kafoury from the plaintiff’s legal team asked Butterworth how much he was being paid by the hospital for his time and gained the answer of $400 per hour. He then asked how many anesthesiologists the doctor had known to be accused of sexual wrongdoing and Butterworth said the Field case was the only one in recent history.

Efaw, Robert Keating and Peter Eidenberg want jurors to better understand the mindset of administrators when the first abuse complaints surfaced. Duane Francis, chief executive officer, and Diane Storby, vice-president of operations, have been accused of not sharing information about allegations of abuse with investigators until after Field’s arrest on July 28, 2011.

They have also been blamed of failure to act on the complaints of victims in 2008 and 2011 and then attempting to discredit the report of Brenda Allen, an employee, who came forward in 2011 to report molestation during a 2007 surgery.

Francis told Police Det. Sgt. Dan Nelson after the investigation into Field’s actions began in May 2011 that it was “improbable on a huge scale” that the allegations of Allen had occurred. Storby pointed out to Nelson that Allen couldn’t remember exactly which surgery the abuse had occurred in and then suggested that her memories were the result of sedating drugs.

Other doctors and nurses picked up that theme of disbelief while on the stand Oct. 15. They talked about the crowded conditions of an operating room, where four to six people are gathered around the patient, along with numerous pieces of equipment. They demonstrated how the hands of a patient are strapped down, making it difficult to imagine that Field could have forced some of the victims to touch his genitalia without being detected.

Nurse Jane Cook had been present during Willie Gmeinder’s surgery Feb. 10, 2011, and testified she had seen nothing unusual while moving around the room. After expressing several statements of disbelief, she was asked directly by Jan Wyers, the attorney representing plaintiff Sharon Hobbs, if she believed Gmeinder, also a plaintiff, had been victimized.

“Do you understand now that a crime happened under your eyes?” he asked.

“I didn’t see it,” she said. “If it occurred, I was not seeing that particular occurrence because I would have reported it myself.”

Efaw told a reporter during a break in the court proceedings that nobody at the hospital was trying to say that Field had not committed the crimes. He said that had already been proven by evidence and the anesthesiologist’s admission of guilt. He said the purpose of Tuesday’s line of questioning had been to explain what administrators would have been thinking after three complaints were registered prior to Field’s arrest.

In September 2012, Field, who had worked at the hospital for five years, pleaded guilty to 11 counts of sexual abuse and one count of rape. He was sentenced to 23 years in prison for the crimes.

“There is no intent on our part to say this didn’t happen. We know it happened,” said Efaw.

Phone records were submitted as evidence Tuesday to show that Storby had made numerous attempts to reach the patient from 2008 who had called in a complaint. Storby contends that the woman never answered any of her messages so that file was put into storage and, over the years, she forgot the patient’s name and the date of her allegations so was unable to readily retrieve that information in 2011.

Gmeinder and plaintiff Erin Vance are represented by Kafoury and attorneys Mark McDougal and Jason Kafoury in the trial that began Oct. 1.

The attorneys for the three victims contend that MCMC had a “culture” that encouraged sexual permissiveness in the operating room. They argue that environment set the stage for Field, described as a “sexual predator” to abuse patients and employees. And, when the abuse happened, Francis and Storby engaged in a cover-up to protect the hospital from liability.

Efaw said in his opening statement that the trial was not about how administrators handled internal issues involving its staff. He said the issue before jurors was whether hospital leaders took reasonable steps to protect patient safety.

He said sometimes things are just as they appear, not some sort of a plot by Francis and Storby to thwart an investigation into possible misconduct. For example, he said Field was not suspended from duty after the investigation into his actions began because law enforcement officials did not want him “tipped off” about their involvement.

As a result of that cooperation, Efaw said Allen’s recorded phone call to Field took place in which he admitted guilt and provided evidence needed to pursue a conviction.

Cook testified that she had been the one to inform Field about Gmeinder’s complaints and suggest he visit the patient. She thought he should be given the opportunity to speak with her because “he was part of the team that was being accused of something happening.”

“I wanted to make sure she was understanding [the possibility of hallucinations] because I did not see any of this going on,” she said.

She said Gmeinder was asked after they arrived if she was comfortable talking with Field and registered no objections.

“She seemed grateful for the explanation. She seemed understanding, it was like the pieces fell together. She seemed okay with the entire situation,” said Cook. “I felt we have given her an explanation to satisfy her that everything we had done was appropriate to the situation.”

The morning after that visit Gmeinder told her surgeon, Dr. Mark McAllister, that the memories had not been real, that she had been informed by Field they were byproducts of the medicine he had used.

McDougal said if Cook had been following the hospital’s “holistic” approach to patient care, her first priority would have been to understand where Gmeinder was coming from instead of explaining away her memories.

“Is it an approach of holistic medicine to have an accusation of sexual abuse occur and then bring the abuser into the room?” he asked.

“At that time, I didn’t think he was an abuser,” replied Cook.

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