Physician in Texas Whistleblower Case Put on Probation by State Board

February 07, 2011

February 7, 2011 — Rolando Arafiles, Jr., MD, the center of a whistle-blowing case that has escalated to criminal charges, has been put on probation for 4 years, fined $5000, and ordered to enroll in a remedial medical education program by the Texas Medical Board (TMB).

In an order announced Friday, the TMB suspended his license but stayed the suspension, meaning that Dr. Arafiles can continue to practice medicine under board monitoring. However, he must take and pass a TMB examination on laws and board rules governing medical practice within the next 12 months. If he fails the exam, given to all would-be physicians in Texas, his license will be pulled immediately. The same thing will happen if he does not successfully complete his required remedial education program within 12 months.

The TMB stated that it reached a mediated agreement with Dr. Arafiles about these terms of discipline while his case awaited a hearing by a state administrative judge. The order constitutes a public reprimand of the 58-year-old clinician, according to the board.

The mediated agreement is the latest development in a story of come-uppance that began when 2 nurses filed an anonymous letter with the TMB in 2009 about Dr. Arafiles and the quality of his patient care. The nurses, Anne Mitchell, RN, and Vickilyn Galle, RN, were his co-workers at Winkler County Memorial Hospital in Kermit, Texas.

Anne Mitchell, far left, and Vickilyn Galle, are 2 nurses who claimed improper medical treatment by Winkler County Memorial Hospital doctor, Rolando Arafiles, Jr., right. Source: Michael Stravato/The New York Times, via Redux/Winkler County Sheriff's Office

When Dr. Arafiles learned of the TMB complaint, he helped Winkler County Sheriff Robert Roberts, Jr., a friend of his, find out who wrote the letter. The nurses were then charged with misuse of official information, a third-degree felony punishable by prison time. The hospital also fired the pair. The charge against Galle was dropped, and a jury found Mitchell not guilty, much to the delight of organized nursing.

In a role reversal, Dr. Arafiles, Roberts, the attorney for Winkler County, and the former administrator of Winkler County Memorial Hospital now face criminal charges in connection with the prosecution and firing of the 2 nurses. The defendants have already agreed to pay Mitchell and Galle $375,000 apiece to settle a civil lawsuit that the nurses filed against them in federal court.

Last year, the state medical board charged Dr. Arafiles with poor medical judgment, nontherapeutic prescribing, failure to maintain adequate records, overbilling, witness intimidation, and other violations. According to the board, he once stitched part of the rubber tip from suture kit scissors to a patient's torn, broken thumb (an attempt to stabilize it, the physician contended). Dr. Arafiles, an advocate of alternative medicine, also rubbed an olive oil solution on an abscess caused by methicillin-resistant Staphylococcus aureus.

The findings of the TMB in last week's disciplinary action did not mention the incident involving the scissors’ rubber tip, but otherwise sketched out the same clinical shortcomings. The board found fault with Dr. Arafiles’ emergency department care, the hormone therapy he administered to patients with thyroid disease, and his decision to order hormone replacement therapy for a woman with a history of deep-vein thrombosis, a contraindication. It also cited him for poorly documenting patient care and intimidating the 2 nurses who had reported him to the board.

The board gave Dr. Arafiles the choice of 2 remedial education programs for physicians, designed to assess someone’s clinical competence and provide retraining as necessary. In addition, Dr. Arafiles must take 8 hours of continuing medication education in medical record-keeping and another 8 hours in evaluating and treating thyroid disease.

When contacted by Medscape Medical News, Dr. Arafiles declined to comment on the board decision.

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