A gynecological cancer doctor who worked for Mission Hospital has filed a lawsuit against his former employer and its owner, HCA Healthcare, contending an inaccurate and misguided disciplinary action against him has prevented him from getting a job for several years.
Dr. David John Hetzel, a gynecological oncologist, left Mission Hospital in June 2020 following an investigation into a problematic surgery that March. The investigation led to a report sent to the National Practitioners Data Bank “for removal of privileges due to a professional review action” and for “negative actions or findings taken by peer review organizations,” according to the complaint filed June 9.
The data bank keeps track of malpractice payments and adverse actions related to physicians, tries to prevent fraud and abuse in health care systems and helps states make informed decisions about handing out licenses.
Hetzel unsuccessfully sought employment at 15 practices between December 2020 and April 2023, according to the complaint. None are based in North Carolina.
“This is a situation where a very good, experienced doctor, working on women with cancer, was essentially blackballed from his career,” said one of Hetzel’s attorneys, Catharine Edwards of Raleigh-based Edwards Beightol. “The report, which Mission knew to have been inappropriate, should have been removed by Mission.”
Hetzel would not comment on the litigation and directed Asheville Watchdog to Edwards.
“Once we have been served with the lawsuit, we will respond appropriately through the legal process,” Mission spokesperson Nancy Lindell said June 23.
His lawsuit seeks more than $500,000 in damages on several counts, including libel, breach of covenant, wrongful interference with economic advantage, and intentional and negligent infliction of emotional distress.
Hetzel was employed by Mission from 2013 to 2020, according to the complaint, which was filed in Western North Carolina U.S. district court against the hospital, HCA Healthcare, and several other related business and management companies.
In 2019, Hetzel announced to the hospital that he intended to resign effective July 2020, according to the complaint, allowing time for a new physician to take his place. Neither the complaint nor Edwards said why Hetzel decided to resign.
In March 2020, Hetzel performed a surgery to remove a gynecologic tumor and encountered problems with the patient’s bowel and colon, according to the complaint. Hetzel called in two other surgeons. They continued to remove the tumor, but also removed all of the patient’s small intestine and colon, which resulted in “high blood loss,” according to the complaint, which noted that was one of the surgery’s risks.
The next day, hospital executives put Hetzel’s clinical privileges on “precautionary suspension” because of the surgery complications and two other organ injuries during surgeries performed in the previous six months, according to the complaint. Hetzel was puzzled by the decision, given that his portion of the surgery was successful, according to the complaint.
A credentials committee of 12 doctors reviewed the surgery and reduced the precautionary suspension to a lesser sanction the next month, according to the complaint. The committee then met with Hetzel to discuss the surgery, though the complaint frames communication between both parties as fragmented.
When the committee ended its investigation, the hospital “concluded that the clinical care that was the subject of the initial precautionary suspension did not warrant a limitation on Dr. Hetzel’s clinical privileges” and fully restored them, according to the complaint.
But in May, the hospital reported the investigation to the National Practitioners Data Bank.
“This report was false and contrary,” the complaint stated, alleging the hospital knew Hetzel’s privileges had been suspended as a precaution, not as a result of a professional review action.
The investigating committee sent Hetzel a letter that June, recommending ways he could improve, the complaint stated. Hetzel decided not to return to work afterward.
A modification to the original report
In July, the hospital submitted a revision-to-action notice to the data bank. The notice modified the original report about the allegedly botched surgery, but did not remove it.
“It did not, at any point, indicate the original filing of the report was made in error or request the revocation or removal of such improper report,” according to the complaint.
The North Carolina Medical Board also completed an investigation of Mission’s report about the surgery and “found no violation of the Medical Practices Act and that the management of the relevant care met the standard of care,” according to the complaint.
The hospital system can withdraw or correct its report about Hetzel but has not done so, according to the complaint.
“The hospital actually has a responsibility to withdraw and/or modify, whichever is appropriate,” Edwards said.
The mark against Hetzel has been flagged during his application to at least 15 medical organizations across the nation, according to the complaint. In Arizona, where he currently lives, he was denied a medical license, according to the complaint.
Edwards said she was aware of the numerous other lawsuits filed against Mission since 2021, including several antitrust, class-action complaints as well as other legal action doctors have taken against Mission, the largest hospital system in Western North Carolina.
“We’re aware that HCA and Mission are under fire on a lot of different levels,” Edwards said. “We’re aware of the antitrust issues and also of the mismanagement issues that have led to lawsuits being filed. … Candidly, I think this touches on both of those things, because it’s an inappropriate action at the management level against a doctor of Mission.
“In addition, they fully understand the implications of a National Practitioners Data Bank report. They fully understand that it makes him largely unemployable elsewhere. It is functioning as a way of restricting his ability to practice medicine anywhere else.”
Asked if she knew of other problematic surgeries Hetzel was involved in, Edwards said, “I don’t think I can really comment on that because we haven’t gone through the discovery process. But he had never been disciplined for any care-related issue.”
The North Carolina Medical Board has no publicly available records indicating Hetzel had a history of problematic surgeries or disciplinary actions.
I hope the patient is ok, but having your intestines and colon removed doesn’t sound like she is. Maybe risk of bleeding is a risk from surgery, but this seems pretty extreme. There must be more to the medical part of the story. What happened to the other 2 surgeons involved? Are they still there?
Sounds like the cancer was more involved and within more organs than a scan could make visible. In ovarian cancer, for example, there can be few if any symptoms until the cancer has wrought havoc into intestines, liver and surrounding parts, resulting in a through “debulking” surgery to remove tumor spread. The doctor immediately brought in other experts to assist, but cancer seems to have spread heavily.
The NC medical board doesn’t discipline much of anything, unless you write shady scripts or have an inappropriate relationship with a patient. They police their own. There is a doctor now at Mission who was fired and license suspended by the State of Tennesee, but was soon after hired by Mission. Its public record and on the Med Board website. Patients need to know the caliber of doctors that Mission is hiring.
Medical boards seem highly conflicted, don’t they?
Yes, medical boards are highly conflicted.
It’s a big problem in many states and especially in the Carolinas. If you know, you know. It’s all behind closed doors stuff that never sees the light of day for the most part.
This is horrifying. The community really must organize around all the wreckage this monstrous corporation is causing in our community–and learn the history of HCA back to FL, under now senator Rick Scott (under a different name, which was changed to HCA I believe) convicted of the largest Medicare fraud in history. As NC State Treasurer Dale Falwell says, they operate like a cartel.
I do wonder about the aspect of not being aware that the cancer had spread. Did he ask for enough tests and the proper tests? What do the other doctors say? It seems this article leaves more questions than it answers.
Sometimes cancer cannot be seen no matter how many tests are done and it is not found until they open the body for surgery.
I’d like to know how much HCA has donated to NC political campaigns if there’s anyway to find that out in this dark money system we have.
Another sad result of Private Equity taking control of medicine. PE is currently buying up individual medical practices and then asking Medicare to allow them to disburse Medicare funds for the care of their patients. The PE entities are required to medical companies themselves. This trial program, begun under Trump, is being continued under Biden and allows the PE administrator to retain any money left at the end of the year after treating patients. In other examples of PE in action, services lag or are discontinued, numbers of employees reduced, salaries trimmed, etc. Gee, I wonder what will be the upshot of PE controlling Medicare? During my lifetime, Wall Street has wanted to get its hands on the Medicare Trust Fund and also Social Security. It appears that they will eventually do so. Some, but not many, may recall that HCA committed the single largest fraud against the Medicare program while Rick Scott was the CEO. Of course he got away “scott-free”.
Dude, PE and HCA are apples and oranges. Not remotely comparable.
Sorry, the PE companies are NOT required to be medical entities.
Makes you go hmm. Believe the Dr. should have stayed within scope of the original surgery. Then allowed for immediate consultation with other physicians if indeed, the cancer had spread. Knowing the invasive nature of cancer, was a comprehensive PET scan completed prior to the surgery? If so, was radiology going to be involved in the overall plan. In other words, was HCA Mission aware of the treatment plan prior to what appears to be a medical emergency.
Is the patient still alive is what I’d like to know. Just because the medical board does nothing doesn’t mean there wasn’t medical malpractice involved. This doctor is opening a can of worms which is a good thing for transparency into the darkness of this dangerous hospital.
I think the focus of this action is the process in place (regardless what you think about it) resulted in a conclusion that Dr. wasn’t in fact guilty of the charges–yet they remain on his record. HCA lied, continues to perpetuate a lie, and isn’t this just typical of them? I hope this doctor destroys this horrid company. Let’s stick with the simple, obvious part of just one more aggressive, damaging thing HCA does to doctors and patients.
HCA is going to be asking, “how many zeros you want on that check!”… they are blatantly in the wrong…