Age Discrimination Lawsuit Exposes Patient Safety Issues: Since the 1980s, neurosurgeon Set Shahbabian performed most of his surgeries at Good Samaritan Hospital, a facility operated by TriHealth. In 2014, at age seventy, Shahbabian sold his independent practice to, and became an employee of, TriHealth. He and TriHealth signed a five-year employment contract with no expectation of renewal.
TriHealth agreed to pay Shahbabian $968,000 annually for satisfying certain productivity metrics. Shahbabian would receive his full salary for the first three years of the contract regardless of his productivity. After that, were Shahbabian not to meet his productivity target, the contract allowed TriHealth to recoup the difference between his compensation and annual productivity targets.
Good Samaritan conditions its physicians’ clinical privileges on their participation in a quality review process. Administered by physicians representing a cross-cut of Good Samaritan’s various departments, this peer review system is designed to identify and remedy improper, risky, or reckless medical decisions. A physician has the right to appeal negative assessments through Good Samaritan’s administrative review process.
Shahbabian’s cases were frequently scrutinized for quality-of-care concerns. In 2011, for instance, one of Shahbabian’s patients sustained excessive blood loss during surgery, was left paralyzed following the procedure, and later died. The surgery peer review committee found Shahbabian’s conduct exhibited “reckless or recurrent at-risk behavior”—the most serious rating a Good Samaritan physician can receive.
In 2012, Shahbabian was cited for “at-risk behavior” because another patient experienced abnormal blood loss.
In early 2015, after he became a TriHealth employee, three more of Shahbabian’s cases were flagged for reckless or recurrent at-risk behavior. One was because Shahbabian’s patient experienced post-surgical complications that required another neurosurgeon to perform a second operation; another because Shahbabian prescribed an unapproved antibiotic that left the patient at risk of severe infection; and a third because Shahbabian failed to remove part of a catheter from a patient before completing surgery. Shahbabian did not appeal any of these findings. Soon after, Dr. George Kerlakian, Good Samaritan’s surgery department chair, issued Shahbabian a correction plan limiting his surgical hours and imposing oversight on his more complicated cases.
Meanwhile, Shahbabian’s health issues were mounting. He was receiving treatment for worsening anxiety, fatigue, and hypertension. Primary osteoarthritis caused his knees to buckle suddenly. Shahbabian’s colleagues saw signs of his physical decline too. Dr. Robert Collins, TriHealth’s chief medical officer, observed Shahbabian grip a wall for support just to walk down a hallway. Shahbabian told his doctor that he did not have the stamina he used to and intended to
work full time until his income protection ended.
Concern with Shahbabian’s quality of care boiled over during a May 18, 2017 surgery peer review committee meeting after two more of his cases were presented. Committee members were frustrated that prior interventions had not corrected Shahbabian’s outcomes and felt that they were “simply running into the same problem over and over and over again.” There was “enough concern [among committee members] that patient safety was in question and Dr. Shahbabian should not be operating.”
Shahbabian, through his lawyer, informed Good Samaritan that he had decided to “voluntarily relinquish” his surgical privileges. Unable to perform surgeries, Shahbabian struggled to meet even his reduced productivity target. TriHealth attempted to renegotiate his employment contract, but Shahbabian rejected proposals that he transition into a non-surgical role. Shahbabian’s contract remained in place until it expired on May 1, 2019. TriHealth declined to renew it. TriHealth then determined that, based on his productivity levels, it had overpaid Shahbabian by $679,711.61. It sent him a reconciliation notice demanding repayment. Shahbabian refused to pay. Instead, he sued TriHealth and Mayfield. TriHealth countersued for breach of contract seeking to recoup Shahbabian’s unearned compensation.
Shahbabian lost at the trial court level, and the United States Court of Appeals for the Sixth Circuit affirmed the loss in its unreported opinion filed on March 9, 2023.
Patient Safety Concerns
Peer review committee discussions are confidential and therefore patients are unable to avail themselves of information that may be critical to their medical decision-making.
Questions: How would you have known about Shahbabian’s “at-risk” surgical behavior history if you were his patient towards the end of his career? Would you have selected him as your surgeon, or the surgeon for a family member, had you known about his recent surgical issues?
If you or a loved one suffered harm due to surgical medical negligence in the United States, you should promptly find a medical malpractice lawyer in your state who may investigate your surgical medical negligence claim for you and represent you or your loved one in a surgical medical malpractice case, if appropriate.
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