November 7, 2011 — Rolando Arafiles Jr, MD, today pled guilty to criminal charges in a state court in Winkler County, Texas, for retaliating against 2 nurses who had anonymously reported him in 2009 to the Texas Medical Board (TMB) over the quality of his patient care.
The case set off a national conversation on the protection afforded healthcare whistle-blowers.
The 2 nurses, Anne Mitchell, RN, and Vickilyn Galle, RN, had worked with Dr. Arafiles at Winkler County Memorial Hospital in Kermit, Texas. Once they were identified as the whistle-blowers by a county investigation that Dr. Arafiles instigated, the nurses were charged with misuse of official information, which is a third-degree felony, and fired. The charge against Galle was dropped, and a jury last year quickly found Mitchell not guilty.
Today, the 59-year-old Dr. Arafiles pled guilty to 1 count each of misuse of official information and retaliation, which is also a third-degree felony. He was sentenced to 60 days in jail and fined $5000. A press release issued by the office of Texas Attorney General Greg Abbott stated that with today's plea, Dr. Arafiles admits to urging former Winkler County Sheriff Robert Roberts Jr and former Winkler County Attorney Scott Tidwell to strike back against the nurses.
On November 4, he signed an order with the TMB to voluntarily surrender his state medical license effective November 11. He faced the possibility of the board revoking his license on account of a felony conviction.
Jail Time for 3 Others in Arafiles Case
Three other individuals involved in the Arafiles affair also received jail sentences and lost their jobs as a result of the roles they played:
Roberts, a close friend of Dr. Arafiles, was convicted of 2 counts each of retaliation and misuse of official information and 2 counts of official oppression, which are misdemeanor charges. He was sentenced to 100 days in jail and 4 years of probation, and fined $6000. Roberts obtained the nurses' confidential letter to the state board through deception, identified who wrote it, and passed the information onto Dr. Arafiles and others, including Scott Tidwell, according to authorities.
Tidwell was convicted of 2 counts each of retaliation, misuse of official information, and oppression and was sentenced to 120 days in jail and 10 years of probation, and fined $6000. He asked a grand jury to indict the nurses and then prosecuted the case against Mitchell.
Stan Wiley, the former administrator of Winkler County Memorial Hospital, pled guilty to 1 count of abuse of official capacity, which is a misdemeanor, and received a 30-day jail sentence. Wiley fired Mitchell and Galle after Roberts flushed them out as the authors of the medical-board complaint.
The 2 nurses had the last laugh in another court proceeding. Dr. Arafiles, Roberts, Tidwell, and Wiley last summer agreed to pay them each $375,000 to settle a civil suit filed in federal court. The suit accused the men of malicious prosecution and violation of their free-speech rights, as well as the state whistle-blower law.
Dr. Arafiles has one legal battle left to fight. In June, a grand jury in Andrews County, Texas, which neighbors Winkler County, charged him with aggravated perjury in the 2010 trial of Anne Mitchell. According to the grand jury indictment, Dr. Arafiles testified falsely when he answered, "I don't know, sir," when asked how then–Winkler County Sheriff Roberts came to possess the home addresses and telephone numbers of the patients listed in the complaint that Mitchell and Galle had filed with the TMB. Aggravated perjury is a third-degree felony in Texas.
Anonymous Complaints No Longer Accepted in Texas
Dr. Arafiles' medical and legal troubles in Texas have been brewing for years. In 2007, the TMB placed a 3-year restriction on his license after determining that he had failed to adequately supervise a physician assistant at a weight loss clinic and to "make an independent medical professional decision" about protocols that the clinic owner had developed for treating obesity.
In response to Galle's and Mitchell's original complaint, the TMB went a step further in February 2011 and put Dr. Arafiles on probation for 4 years, fined him $5000, and ordered him into a remedial medical education program. Dr. Arafiles was faulted for his 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, which is a contraindication. The board also cited him for poorly documenting the care he rendered and intimidating Mitchell and Galle after they reported him to the board.
According to the board, Dr. Arafiles once stitched part of the rubber tip from suture kit scissors to a patient's torn, broken thumb (Dr. Arafiles said he was trying to stabilize it). Dr. Arafiles, known for his advocacy of alternative medicine, also once rubbed an olive oil solution on a patient's abscess caused by methicillin-resistant Staphylococcus aureus.
If Mitchell and Galle had waited until now to submit their unsigned complaint to the TMB, Dr. Arafiles might not have had a run-in with the judicial system. Earlier this year, Texas passed a law that prohibited the TMB from acting on anonymous complaints about physicians. The issue has been a hot one since 2007, when a physician group called the Association of American Physicians and Surgeons sued the TMB to stop it from soliciting or accepting anonymous complaints. The association claimed that the TMB misused anonymous complaints to "harass and intimidate their competitors and adversaries."
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Cite this: Texas Physician Pleads Guilty in Whistle-Blowing Nurses Case - Medscape - Nov 07, 2011.