VA Physician Fails To Appreciate the Gravity of His Conduct

The physician who misplaced so many radioactive seeds in prostate cancer patients, Gary D. Kao, M.D., has admitted to making some errors, but denies that he violated the standard of care owed to his patients. While stating to a senate panel that "we can do better," Dr. Kao also said, "Brachytherapy was and still is an evolving field" (code for Hey, surgery is complicated. What do you want from me?). What's more disturbing, however, is that he "acknowledged that he never informed patients when he missed the prostate or delivered insufficient doses."

Read the full story from the Associated Press here.

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Hearing To Be Held In Philadelphia VA Malpractice Case

Hearings are being planned in connection with the malpractice committed at a Philadelphia Veterans Hospital involving brachytherapy. Senator Arlene Specter, who has taken charge in the matter, has said that the case involves "more than medical malpractice." Read the full story in the Philadelphia Inquirer.

How To Protect Yourself Before Undergoing Brachytherapy

A truly horrifying story appeared in Sunday's New York Times about a cancer unit in a veteran's hospital in Philadelphia. According to the story, one of the unit's doctors, Gary D. Kao, M.D., on numerous occasions improperly implanted radioactive seeds in patients with prostate cancer causing serious complications. Usually, during this relatively common procedure known as brachytherapy, a surgeon places radioactive seeds close to a cancerous tumor. The procedure is often done in place of or in conjunction with external beam radiation. According to an investigation by the Times and federal authorities, during brachytherapy Dr. Kao was often placing the seeds in the wrong organ then attempting to cover up his errors.

My reading of the story offered two clues for how patients seeking to undergo this procedure can protect themselves from surgeons like Dr. Kao. The story noted that there was no peer review at the V.A. hospital. All good hospitals have some kind of peer review procedure wherein physicians at the same institution look over each others' shoulders, reviewing one others' work. Bad outcomes are discussed openly and frankly with the goal of avoiding them in the future. Ask your surgeon if the hospital where your surgery is to take place has peer review procedures in place.

The other way you can protect yourself is to ask your surgeon about his or her experience performing that particular procedure. The Times article pointed out that Dr. Kao had a medical degree from an outstanding institution and was board certified in radiation oncology. However, he had "limited experience in brachytherapy."