FORT MOHAVE — In August, a group of 12 doctors at Valley View Medical Center signed a petition and presented it to the board of trustees demanding hospital management address a wide range of practices that endanger or potentially fatally harm patients and run up bills for service to increase profits.
The petition, signed by doctors Anees Arshad, Irfan Mirza, Ihtisham Choudry, John Adan, Nabila Aslam and David Freedman, among others, alleges that the acute care facility doesn’t provide enough staffing to the cardio catheter lab to conduct lifesaving tests and procedures outside of weekday business hours; transfers patients to its sister hospital Lake Havasu Regional Medical Center when services could be performed at Western Arizona Regional Medical Center; forces unnecessary transports because of unavailability of operating room support staff; allows CEO Jiron Feliciano regularly to forces case managers and quality control departments to change diagnoses for higher reimbursement purposes.
“This has led to the death of several patients sitting in the ER,” the petition stated.
According to several doctors who signed the petition presented to Rhonda Letcher, chairman of the board of trustees, no steps were taken to remedy any of the doctors’ concerns.
The cath lab allows medical staff to provide a variety of life-saving and heart-protecting services, including stenting and balloon angioplasty procedures as well as measuring pressure and oxygen levels in different parts of the heart, analyzing pumping function and obtaining biopsy samples, according to the Mayo Clinic.
One heart patient still upset about her experience with VVMC is Melissa Martin. In late June 2017, Martin, 50, suffered a heart attack and in July of that year underwent heart bypass surgery and placement of a mechanical aortic valve at University Medical Center in Las Vegas, she said.
Martin was home in Bullhead City by September. While she couldn’t resume her work as a freelance makeup artist things seemed to be looking up.
“I was feeling pretty good,” she remembered.
On Dec. 30, Martin and her husband, Joel Wales, were home when Wales became concerned about his wife’s condition. Martin looked very swollen and was having trouble breathing, Wales said.
“We didn’t know very much about either hospital and my husband decided to take me to Valley View,” Martin said.
On Dec. 30, Martin was admitted and a doctor said she was having congestive heart failure, the term that describes a heart working less efficiently than normal, she said. Martin was airlifted to University Medical Center but sent home after an overnight stay that allowed staff to monitor her heart, she said.
Martin’s condition declined rapidly on the way back from Las Vegas and they immediately returned to VVMC, Martin said.
By 6 a.m., New Year’s Day 2018, she had suffered another heart attack.
According to Mirza, a cardiologist was expected to arrive at the hospital to evaluate her condition but had not done so after more than 12 hours. Because her condition was so serious by that point, Martin was airlifted to WARMC for surgery.
“They saved my life,” Martin said of the WARMC staff. “I could have died.”
A patient report verified that Martin needed intervention because she was in grave danger of suffering what is known as a “widowmaker” — a critical blockage at the beginning of the main artery.
Martin said she believes her problem could have been resolved earlier, possibly avoiding the News Year’s Day heart attack and additional expense, if VVMC staff hadn’t moved her to a Las Vegas hospital.
“I don’t know why they didn’t send me to WARMC in the first place or do the procedure themselves instead of putting me into a helicopter and flying me to Las Vegas,” she said.”I was airlifted twice in 48 hours.”
Cost for air medical transport can exceed $50,000 and not every patient has insurance coverage for it, according to VVMC staff members.
A mid-career nurse, who asked not to be identified out of fear of professional reprisals, said ER staff often prefers to transfer patients to other hospitals because they don’t want to be responsible for them.
The doctors’ petition asserts that staff is encouraged to find ways to airlift patients to Havasu Regional Medical Center, another LifePoint affiliated facility, instead of to WARMC. And, if the Havasu hospital isn’t suitable then it’s preferred to send the patient to a Las Vegas facility.
“This is not a joke, these are people’s lives,” said Mirza, a cardiologist, internist and interventional cardiologist. “The hospital is not acting as a hospital but rather as a collection and triage center. We’re not selling ice cream, we are dealing with human life. This selling of the human body has to stop.”
Another patient went through a harrowing five days at VVMC in mid-December. The experience included having a staff member confuse her with another patient who needed surgery for a completely different problem.
Beverly Simmons went to a local walk-in clinic because she was congested and severely coughing. After determining she was suffering from atrial defibrillation, a high heart rate and high blood pressure, staff advised her she was in serious condition and referred her to the VVMC Emergency Room for further care, Simmons said.
She spent several hours in the ER before space became available in the Intensive Care Unit.
“I was well taken care of in the ER and ICU,” Simmons said.
After an overnight stay in the ICU she was moved to a regular bed. Simmons said a cardiologist told her she would be able to go home the next day but that the hospitalist needed to sign off on that as well.
While awaiting discharge, Simmons said she became nauseous. She rang twice over a period of 20 minutes for help from staff but was ignored, Simmons said.
“Even though I was identified as a fall risk, I gathered up my IV tubing and pushed the (IV) pole down the hall to the nurses’ station to beg for help,” she said. “My nurse was standing there doing paperwork — he watched me come toward him down the hall but made no effort to help me.”
The nurse helped — and apologized — a few minutes later. But after the hospitalist suggested another doctor evaluate her to determine why she became nauseous, he “insinuated that I was having an anxiety attack and that he could give me something for that.”
Simmons said one of the doctors thought her trouble was caused by a gallbladder problem. Tests were ordered even though she explained it wasn’t likely the cause of her problems. The CT scan alone cost $11,000.
“Imagine my shock when I saw the bill!” Simmons said.
A technician noted that she didn’t seem to have a gallbladder issue but moved forward with that test anyway, causing intense discomfort, including “dry heaving so loud you probably could have heard me in the parking lot,” Simmons said.
The doctor who ordered the CT scan ultimately determined that she didn’t have a gallbladder problem. Simmons said he told her that “the CT scan must have been a little sensitive.”
And the food served during her stay didn’t seem as if it was appropriate for a cardiac patient. Main dishes were such things as a cheeseburger, fish and chips, and macaroni and cheese, Simmons said.
According to Simmons, the worst part of her hospital visit was when she was told by a nurse that she was having a heart attack and that she needed to have a stent procedure within minutes.
“I asked for a short reprieve to brush my teeth and call my husband,” she said.
Simmons mentioned her doctor’s name and said she thinks that alone caused the staff member to leave the room and verify who Simmons was. The nurse returned, apologized and said Simmons wasn’t the patient she had thought.
“Had I not asked for those few minutes to pull myself together I would have gotten into the wheelchair and been whisked away for a procedure I did not need,” Simmons said. “Hopefully someone along the way would have figured it out.”
While her other two doctors were willing to sign her out so she could finally go home, the hospitalist insisted on making her wait around for hours. Simmons said she believes this was only to charge her more money.
The doctors who submitted the petition in August also assert that operating room crews are only available 14 out of 30 days each month, resulting in many patients being transferred to other hospitals, such as Havasu Regional Medical Center.
One VVMC nurse told The Daily News that staffing is too low for many of the hospital’s functions because of too much emphasis on the financial bottom line: “It’s a budget thing.”
And another staff nurse agreed with that nurse’s opinion on staffing.
Patient-to-nurse ratios “are unsafe,” she said.
This nurse, who also asked to remain unnamed, said that she has noticed that some patients aren’t checked into the ER, which is supposed to be a hard-and-fast rule.
When patients are moved from rehab to critical care without the ER care in the middle, it can delay care they need to have the best possible future outcome in cases of heart attacks, strokes and other problems, she said.
While low ER staffing is sometimes why this happens, she said it appears to also allow them to skirt laws that require they take care of people brought into ERs who might not have insurance.
The doctors’ petition points to a variety of other risky hospital practices: Not trying to meet the monetary demands of the hemodialysis provider by allowing them to leave rather than negotiate as well as not working with local nephrologists.
“Facts regarding Mr. Jiron Feliciano’s lack of empathy, arrogance, reckless behavior has led to the lowest moral among physicians, nurses and patients because of his actions,” the petition stated.
It goes on to cite numerous other managerial faults.
The doctors on the petition and a mid-career nurse stressed that staff truly wants to see things at the hospital improved. They hope that talking about such problems won’t result in the hospital’s care being scaled back or that the facility is closed.
“This community deserves the best care we can provide,” the nurse said.
Mirza has filed suit against the hospital and PHC-Fort Mohave Inc. for wrongfully suspending him, then just last week, notified him that they terminated his “staff membership and clinical privileges,” according to a complaint filed with the Mohave County Superior Court.
“Some of us believe that if someone has entrusted us with their care, given me a roof to house my family and embraced me in their community, I owe them loyalty,” Mirza said. “This is not about me. They are hurting people. I’ll take this as far as I need to go to ensure patients are cared for.”
Mirza said he believes his dismissal from VVMC is a direct result of speaking out against practices he said are dangerous and illegal.
“As a matter of practice, Valley View does not discuss any personnel or medical staff matters,” wrote Ryan Perkins, market director of marketing and communications for VVMC and HRMC, in an email in regard to Mirza’s dismissal.
Continued efforts Thursday afternoon to obtain comment about the petition from VVMC were unsuccessful.