Starkman: Beaumont Health's Culture of Deceit and Intimidation Imperils Patient Safety

January 29, 2021, 9:57 PM

The columnist, a Los Angeles freelancer, is a former Detroit News business reporter who blogs at Starkman Approved.

By Eric Starkman

Richard Curbello and fiancee Connie Strong

The integrity and character of a company’s management aren’t defined by the platitudes its PR people serve up. Rather, it’s by their actions, particularly in the wake of a calamity they were ultimately responsible for.

Patients considering surgery or other treatments requiring sedation at Michigan’s biggest hospital network should be aware of how Beaumont Health and the controversial outsourcing company providing anesthesia services at its flagship Royal Oak hospital are responding to the death of a 51-year-old man undergoing a colonoscopy because of complications from an intubation. The company, Texas-based NorthStar Anesthesia, was awarded its contract last June by COO Carolyn Wilson and assumed responsibility at the start of this month.

Beaumont and NorthStar both issued the obligatory “we mourn the loss” and “we express our deepest sympathy,” statements. But the management actions of both companies since the colonoscopy incident suggest they aren’t overcome with grief over the passing of Richard Curbelo, who died Jan. 21.

Within about an hour of Deadline Detroit posting my story Monday that a colonoscopy patient had died at Beaumont, Sandra Geary, NorthStar’s chief compliance officer and the company’s former COO, sent an email to Beaumont’s anesthesiology staff notifying them an “investigation” into the “origin” of the report was underway. Geary warned them of all the bad things awaiting those involved, including termination, litigation and fines.

Sandra Geary (Photos: LinkedIn)

To heighten fears, Beaumont Thursday night sent an employee communique also saying an investigation was underway and that it had already been determined some staff members “might have” inappropriately accessed Curbelo's medical record.

“We will appropriately deal with those who have violated privacy policies and laws,” the communique thundered. It was signed by eight hospital executives, but notably absent from the signatories was CEO John Fox, Chief Medical Officer David Wood Jr., and Wilson, who proudly announced NorthStar’s hiring last June.

Beaumont’s communique, which didn’t refer to Deadline Detroit by name, said my story contained “false information,” which couldn’t be corrected because of patient confidentiality.

If my story was false, Beaumont spokesman Mark Geary shouldn’t have ignored me when I sent multiple emails outlining the information I was planning to publish. Connie Strong, Richard Curbelo’s fiancé, confirmed the details of my original story. Strong reached out after it was published.

Mark Geary

In fairness to Beaumont spokesman Geary, he has good reason to despise and ignore me, as I’ve previously published a column questioning his and John Fox 's truthfulness for issuing statements that were inaccurate or misleading.

Still, it’s reasonable to expect a PR professional to put animosity aside when confronted with information that is supposedly false and quite damning to the company he represents.

It’s not my practice to discuss the sourcing of my stories but I’ve learned that Beaumont is conducting a witch hunt and hauling employees into HR and questioning their involvement. I fear that some innocent person might stand falsely accused.

This might come as a surprise to NorthStar’s Geary, who like CEO Fox is an accountant by training, but in the tightly knit medical world a patient dying undergoing a colonoscopy is a mighty big deal.  News of the tragedy traveled fast, as this was the accident many believed was inevitable. Beaumont’s co-heads of cardiology alerted hospital chairman John Lewis in September they had “serious concerns” about NorthStar’s standards of care.

Medical community disdain

The person who tipped me off to the tragedy wasn’t a Beaumont employee. Here’s one more identifying detail: The source has a low regard for NorthStar. Good luck finding the person matching this description.

The source’s opinion is widely shared among people I’ve spoken with in the anesthesiology field. There’s a reason why NorthStar is derisively referred to as “Death Star” on industry message boards.

The moniker alludes to the space station in the Star Wars franchise capable of destroying an entire planet. NorthStar’s business model is to gain market share by undercutting competitors with low bids and then relying on less experienced or roving anesthesiologists and Certified Registered Nurse Anesthetists (CRNAs) to boost its profit margins.

An Ohio jury in 2018 awarded the family of a deceased man $1 million, after finding a CRNA under the direction of NorthStar Anesthesia at least partially responsible for his death. The NorthStar CRNA allegedly failed to maintain the man’s airway properly, which led to his eventual death.

Elizabeth Squire

Texas-based NorthStar is controlled by The Cranmere Group, whose previous CEO Jeffrey Zients resigned in December to co-head President Biden’s transition team and will oversee the administration’s Covid response. NorthStar spokeswoman Elizabeth Squire, who works in the Washington office of Trident DMG, said Zients has no financial interest in Cranmere.

Fox 2, which picked up Deadline Detroit’s story about Curbelo’s death Wednesday evening, published a statement from Squire referencing “false assertions” in Deadline Detroit’s reporting. Squire’s statement maintained that the “vast majority of our physicians and CRNAs are deeply rooted in their local communities, and some had previously worked at Beaumont for decades.”

The statement is misleading. To meet staffing demands of Beaumont’s surgical business, NorthStar relies on temps and anesthesia staff from other hospitals where it has contracts across the country. It also has been using the services of Roland Kaddoum, visiting from Beirut.

Kaddoum is the brother of Romeo Kaddoum, NorthStar’s regional chief medical officer for the Detroit area. Squire said that Roland Kaddoum is a pediatric anesthesiologist who did his training and fellowship in Detroit. She said Romeo Kaddoum doesn’t directly oversee his brother, which is why the two are permitted to work at NorthStar.

'Exceptional Performance'

NorthStar was chosen by Beaumont “because of its track record for quality and for its experience working in the Michigan market,” Squire said in an email Friday.

In 2019, she said, NorthStar received a score of “exceptional performance” in 24 of 27 of its reporting entities nationally (including all of its Michigan facilities), placing it at the 95th percentile of performance.  Squire said the score specifically accounts for quality of care, resource use and clinical practice improvement activities for anesthesiology.

Squire maintained that 75 percent of the anesthesiologists at Beaumont Royal Oak joined NorthStar. Multiple sources I’ve talked to dispute that number, saying it's closer to 50 percent. In any event, a 25-percent anesthesiologist turnover is significant.

NorthStar's representative also disputed an unidentified source I cited saying that Beaumont previously required that all intubations be done in surgical suites: “This is false. Patients are regularly intubated outside of the surgical suites at Beaumont’s facilities, and NorthStar has not deviated from the standard of care.”

The threatening communique Beaumont sent employees Thursday night stated: “Safety remains our top priority.” That claim is undermined by the fact that Beaumont’s medical staff has yet to receive the results of an internal “Culture of Safety” survey conducted last fall gauging their views of the hospital’s protocols to ensure quality patient care. Speculation is rife that the results are so damning that Fox, Wilson, and Wood want it kept under wraps.

Beaumont nurses were informed this month that a patient satisfaction survey didn’t meet the threshold to obtain a coveted Magnet status, a designation of excellence in nursing and patient care.

The threatening communiques from the managements of both Beaumont and NorthStar underscore the reign of terror that’s overtaken the hospital network under the leadership of Fox and Wilson. Former head of pediatrics Brian Berman was fired after protesting that cuts to his department would imperil patient care, as was a doctor who protested Berman’s firing.

Wouldn't Let Family Get Treated

Beaumont’s medical staff is comprised of longtime employees who once took great pride in working there, even though many could earn higher pay elsewhere. They feel obligated to get word out about dangerous patient safety conditions because many wouldn’t allow their families to get treated at Beaumont as long as Fox, Wilson, and Wood remain in charge.

Dr. Karen Sibert (Photo: UCLA Health)

Karen Sibert, an anesthesiologist with more than thirty years of experience and the former president of the California Society of Anesthesiologists, said it takes considerable bravery for hospital workers to risk their jobs to call attention to their safety concerns.

“Usually, there are internal mechanisms within a hospital for confidential reporting of hazards or adverse events so that quality review can take place and safety can improve. But when those channels fail -- when physicians or employees risk their jobs if they complain or point out inadequacies -- then there's no recourse but to go public. This takes tremendous courage,” Sibert said.

Sibert also cautioned against blaming the NorthStar anesthesiologist and CRNA who worked on Curbelo as being responsible.

“Every adverse event such as a death under anesthesia needs a thorough system review of the resources, supplies, staffing ratios, and every other factor that may have contributed,” Sibert said. “The anesthesia team probably will be blamed but they may have been working in an understaffed, under-resourced setting. My heart really goes out to them. I can't imagine the grief they must be feeling.”

My sense after reporting on Beaumont since last April is that Beaumont’s and NorthStar’s managements focus more on employee witch hunts rather than on thorough system reviews. Otherwise, the tone and tenor of their communiques would have emphasized enhanced safety protocols, not retribution.

R.I.P. Richard Curbelo. While I’m doubtful that the executives ultimately responsible for your botched care are overly burdened, I assure you there are legions of Beaumont doctors and nurses who are devastated by your passing.

Reach Eric Starkman at Beaumont employees and vendors are encouraged to reach out, with confidentiality assured.
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