Physician Mocking Patient Draws Suspension, Investigation

Kerry Dooley Young

June 25, 2018

A video of a physician mocking a patient drew about 6 million views on Facebook. In the wake of this incident, a California hospital effectively ordered its medical-staffing contractor to keep the involved employee out of its emergency departments in the future.

"A patient who visited the emergency department at our Los Gatos campus had an interaction with a physician whose demeanor was unprofessional and not the standard we require of all who provide care through El Camino Hospital," said the hospital's chief executive officer, Dan Woods, in a statement provided to Medscape Medical News. "We have expressed our sincere apologies and are working directly with the patient on this matter."

Woods also said El Camino told the company with which it had contracted to provide emergency services, Vituity/California Emergency Physicians, to remove this physician from the list of approved physicians assigned to provide emergency care at its hospitals.

"This matter is being immediately addressed at the highest level of our organization; however, patient privacy laws prevent us from providing specific information regarding the treatment or services provided to any patient under our care," Woods said. "Please be assured that this recent interaction is not reflective of the care and services our over 3000 dedicated caregivers provide every single day."

Vituity, which changed its name this year from CEP America, said the physician involved will not be allowed to return to the hospital, without naming her. Vituity would not clarify whether the physician remains connected to the firm.

"After learning of the behavior of one of the physicians within our organization at the El Camino Hospital Los Gatos emergency department, we immediately removed her from all hospital schedules," said Allison Kundu, director of marketing for Vituity, in a statement. "We take this matter very seriously, and our investigation process is underway."

Vituity said it intends to continue to "strengthen" its physician training programs to prevent another incident of this kind.

"We also take great pride in our physician vetting process and ongoing quality control, including performance reviews to assess clinical performance, communication, and team-building skills," Kundu said. "These reviews are in addition to ongoing tracking of quality indicators, patient surveys, and local hospital and medical staff review processes."

Donald Bardwell, who posted the video and is the father of the patient, told Medscape Medical News that he openly recorded the incident to try to get the physician to change her behavior toward his son. He asked that friends on Facebook share the video, posted on June 12, saying: "This is how they treat black people in Los Gatos emergency room."

Bardwell said it appeared that the physician had decided his son was trying to get narcotics without even trying to understand the young man's medical condition.

On June 11, 20-year-old Samuel Bardwell collapsed with an anxiety attack after a basketball practice, owing to what the family now believes was a reaction to intermittent dosing of clonazepam (Klonopin, Roche), his father said. The San Jose Mercury News reported that West Valley Community College basketball coach Scott Eitelgeorge called 911 after finding Samuel collapsed on the grass outside of a weight room.

Bardwell said Samuel is a college student who, in addition to his sports activities, also has a job. Because of his busy schedule, he was not able to pick up his medication at a pharmacy, his father said.

"It's hard going to work, going to school and trying to play basketball," Bardwell said. "He'd hardly have time to eat. He wasn't thinking about taking his meds. He just put it off."

Bardwell told Medscape Medical News that he joined his son at El Camino Hospital, where they waited for about 3 hours before the encounter with the physician. Bardwell said that from the start of the visit, she appeared to think his son was seeking drugs. He said he began to openly record the visit in the hope that doing so would persuade the physician to take his son's complaints more seriously.

The video opens with Bardwell's voice heard trying to explain to the physician that his son has been "going in and out of consciousness." The physician stands over the gurney where Samuel rests.

"He's completely awake and alert right now," the physician says on the video.

She tries to get Samuel to rise from the gurney. "You are the least sick of all the people here, who are dying," she tells him, and then argues that since he could lift his head, he should be able to get up. "Don't try to tell me you can't move."

The physician then takes his left arm and tries to get Samuel to sit up.

"She's literally yanking my arm," Samuel says, maintaining that he's unable to fully rise.

"You want us to wheel you to your house in the gurney?" the physician asks him.

The physician and Samuel continue to argue about whether he is able to get up. When Samuel tells the physician that he can't inhale, she laughs.

"He can't inhale. Wow. He must be dead," she says, seemingly to someone out of range of the video, before turning back to Samuel.

"Are you dead, sir?" she asks him. "I don't understand. You are breathing just fine."

Bardwell, who told Medscape Medical News that he previously worked as an emergency medical technician, is then heard on the video reporting to the physician that his son's breathing has been labored. The physician argues back, pointing seemingly to a monitor and saying that Samuel has an oxygen saturation of 100%.

Bardwell and the physician then debate about the cause of Samuel's pain. The physician maintains that it stems from his workout, while Bardwell says that his son received fluids and a pill for pain and anxiety on a previous emergency department visit.

"So you need narcotics? Is that what you need?" the physician says, addressing Samuel directly.

Samuel replies that he had not asked for narcotics but only for a pain reliever and anxiety medication. "I said nothing about narcotics," he says.

The physician and Samuel then argue further about his condition before the physician tells him that he is "full of shit."

"You know, I came in here wanting to help you, and you're just turning your story around," the physician says.

Samuel and the physician then debate about who has changed the story about what he sought.

"No, you have changed your story every f---ing time," the physician says, clearly shocking her patient.

"Put an IV in him, give him a liter fluid, and we'll get him out of here," the physician says as the video concludes. "That's what he says he needs. He's obviously a doctor."

Minnesota Action

Dr Beth Keegstra. Donald Bardwell

The physician in the incident at El Camino Hospital has been identified in news reports as Beth Keegstra, MD. Photos of Keegstra from LinkedIn and Facebook accounts that predate the incident at Los Gatos match that of the physician shown in the Facebook video posted by Bardwell. The LinkedIn profile indicates that Keegstra has worked with CEP America, as Vituity previously was known, since 1997.

Multiple attempts to reach Keegstra directly were unsuccessful, as was a call to an attorney who represented Keegstra in a Minnesota disciplinary action. Keegstra also lists the Mayo Clinic as an employer.

The Mayo Clinic confirmed that Keegstra was a "supplemental" employee at its Fairmont, Minnesota, site from January 2013 to January 2016. She was not on staff, but worked on contract on an as-needed basis, a Mayo spokeswoman said in a statement. The spokeswoman also said Mayo made a complaint to the Minnesota Board of Medical Practice regarding Keegstra that ultimately resulted in public corrective action being taken against her.

The Minnesota board found that Keegstra failed to establish a formal physician-patient relationship with the patient and did not create a chart within the clinic system for the patient. The board also said she failed to consult the Minnesota Prescription Monitoring Program regarding the patient because she was unaware of the program, and thus prescribed "various medications" to the patient from October 2015 through January 2016.

Keegstra agreed to take a course on professional boundaries and to write and submit a paper describing what she had learned from the required coursework, the board said in the agreement. The board said Keegstra's report should show how she implemented this knowledge into her practice and how she will use the Prescription Monitoring Program.

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