State health officials have suspended the license of a Richland obstetrician, saying there’s evidence he “has committed a high volume of malpractice and patient abuse” and “represents an immediate danger to the public health and safety.”
Dr. Alexander M. Ortolano has 20 days to respond to the summary suspension.
The doctor couldn’t be reached for comment Thursday by the Herald, but Bob Meals, one of his attorneys, said Ortolano poses no threat and “there was never any abuse.”
Some issues were raised in a separate process a few years back and were corrected, and there have been no issues since, said Meals, who is based in Montana.
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The state Medical Quality Assurance Commission is “way off base and failed to follow fair procedure,” Meals said, adding, “we are going to take immediate steps to correct it.”
Meanwhile, an attorney representing a patient in one of three medical negligence court cases pending against Ortolano said the commission took the right action.
“We all feel very relieved that Dr. Ortolano is not seeing patients today,” Kristi McKennon said.
McKennon, a Kennewick attorney, expects to bring additional claims on behalf of other patients in the future.
“My clients are thankful for the hard work of the Department of Health, the Medical Quality Assurance Commission, its investigators, attorneys and (others) who spent countless hours preparing the statement of charges and the order,” she said.
McKennon added that the statement of charges “was shocking, even to us.”
The 20-page document alleges Ortolano’s care of 17 patients who had babies between December 2011 and March 2013 “reveals substantial concerns about (his) competence, skill, judgment, and his character and overall safety to practice.”
He has “engaged in a pattern of grossly substandard care and patient abuse that created unreasonable risk of harm and caused patient harm,” it said.
Among the specific allegations in the statement of charges and summary suspension order:
• Ortolano performed many unnecessary procedures and services, including unnecessary dilation and curettage procedures that in some cases were done in an “overly vigorous manner.”
Some of the patients “suffered damage to their uterus, including at least three hysterectomies, one uterine perforation followed by a difficult course in the intensive care unit, and one diagnosis of Asherman’s syndrome.”
While the motive for the unnecessary services and procedures isn’t known, “one effect was that these services increased the amount of potential financial reimbursement,” documents said.
• His “extremely rough” placement of the cervical ripening insert Cervidil “caused patients to thrash around or cry out in pain.”
Although the placement commonly is done by nursing staff, he insisted on placing them himself and he would routinely administer the narcotic Fentanyl beforehand, though placement shouldn’t be significantly painful, documents said.
• Ortolano “failed to respond in a timely and appropriate manner to patients who experienced complications requiring emergency treatment, such as blood loss and uterine rupture,” documents said.
• He took on a high number of deliveries, putting mothers and babies at risk, and induced labor more than his peers, delivered babies with lower Apgar scores and had more babies in need of neonatal intensive care stays.
• In one case, he left a C-section after making an incision in order to deliver another baby, although another obstetrician was available for that delivery. “The patient undergoing the C-section remained under anesthesia with an open surgical wound for
approximately 15 minutes while (Ortolano) ‘broke scrub’ and left the operating room to attend to another patient. (He) then left the vaginal delivery patient with an un-repaired laceration and without having delivered the placenta to return to the operating room,” documents said.
• His documentation was substandard and at times “dangerously untimely.”
Ortolano’s privileges at Kadlec Regional Medical Center in Richland were revoked last fall over safety concerns, documents said.
He is part of Arbor Healthcare for Women. The practice has other providers and remains open.
The health department documents are available online at www.doh.wa.gov by clicking on “Licenses, Permits and Certificates” and then “Provider Credential Search.”