In #MeToo era, a call for more scrutiny of doctors who get arrested
Posted April 27, 2018 9:53 a.m. EDT
(CNN) — A Miami hospital's decision not to suspend a pediatric surgeon who was arrested on felony charges is renewing questions about whether hospitals are doing enough to keep patients safe from doctors who may have committed crimes.
The doctor was arrested in December and accused of "cybersnooping" on his now-ex-girlfriend. Prosecutors accuse him of logging into her home security cameras almost daily -- sometimes several times a day -- without her permission or knowledge, according to an arrest warrant.
The hospital where he works, Nicklaus Children's Hospital, did not suspend him after his arrest and two months later published on its website a glowing article about his work.
Hospitals have long been criticized for being too easy on doctors who are accused of questionable behavior, and those concerns have escalated in the #MeToo era.
Hospital disciplinary programs for doctors are mostly "a sham," according to Dr. Robert Wachter, chairman of the Department of Medicine at the University of California, San Francisco. "It is undeniable that hospitals do have a tendency to protect their own, sometimes at the expense of patients," Wachter wrote in his 2005 book, "Internal Bleeding: The Truth Behind America's Terrifying Epidemic of Medical Mistakes."
The pressure on hospitals to be tougher on doctors has increased in the past few months, with The Washington Post, NBC News and others publishing investigations of doctors' behavior.
"The old-school view is don't take surgeons offline; they're valuable. But in the era of #MeToo, we've got to protect patients first," said Art Caplan, director of the Division of Medical Ethics at New York University Langone Medical Center.
Protecting patients means paying attention to signs that a doctor's behavior might be troubling, said Caplan and other experts who've dealt directly with doctor discipline issues.
These experts said that at their hospitals, the Miami surgeon, Dr. Colin Knight, would have been suspended while the hospital undertook a full investigation. They said doctors should be suspended and investigated even if the concerns have nothing to do with their technical skills.
If Knight really did cybersnoop on his ex-girlfriend, that raises "red flags," said Dr. John Lantos, director of pediatric bioethics at Children's Mercy Hospital in Kansas City, Missouri. "If he's a voyeur, will he be harming patients?"
"It makes me concerned, if he really did do something like this, what could he do to patients?" said Dr. Benard Dreyer, former president of the American Academy of Pediatrics.
Caplan added, "I would be aggressively managing this to make sure there's no doubt I wasn't watching out for children."
In December, Knight was arrested on charges of offenses against computer users, accused of cybersnooping on Grace Carricarte, a therapist and adjunct professor at the University of Miami.
During a five-month period in 2017, Knight accessed Carricarte's security system almost daily, where he was able to watch her through five security cameras she'd placed in and around her home, according to the arrest warrant.
He accessed her account from his home and from the hospital, often more than five times a day, and sometimes as many as 10 to 16 times per day, according to the warrant.
Knight's attorney, Alexander Fox, disputes those numbers, saying Knight logged into Carricarte's security account approximately two to five times a day.
When asked to explain the discrepancy between his numbers and the numbers in the arrest warrant, Fox said prosecutors had told him that the "all of the logins they initially allege were not really logins."
The prosecutors' office said he's wrong.
"We would strongly disagree with Mr. Fox's characterization of the case and his contentions," Ed Griffith, a spokesman for the Miami-Dade State Attorney's Office, wrote in an email.
The logins occurred while Knight and Carricarte were dating and after they'd broken up. Carricarte now has a restraining order against Knight, who also was ordered to give up the two guns he owns.
According to Knight's lawyer, Carricarte gave him her login and password and asked him to watch her security video feeds because she feared for her safety. He denies the charges and has pleaded not guilty.
Carricarte, who said she put in the security cameras after her home was burglarized, denies that she ever asked Knight to watch her security cameras or gave him her login or password. She said he figured it out because it's similar to her home Wi-Fi login information, which he knew.
Nicklaus Children's Hospital did not at any time suspend Knight's privileges to practice at the hospital, his lawyer said.
According to hospital spokeswoman Jennifer Caminas, "the doctor has clinical privileges and the matter remains under review."
Caminas declined to give details about that review.
The experts contacted by CNN said that even with the criminal investigation, it's still the hospital's responsibility to try to find out whether Knight had issues at work.
If Knight did what he's accused of doing, Lantos said, he'd be concerned about him being given access to patients, and the hospital needs to ask questions.
"Is he the sort of person we want on our hospital's staff?" asked Lantos, a professor of pediatrics at the University of Missouri-Kansas City School of Medicine. "It's our professional responsibility to police ourselves."
Other experts agreed.
"Our first responsibility is to patients, and I would be concerned if someone was capable of doing what he's accused of. Might they not have the judgment and ethical requirements to be a physician?" added Dreyer, who is chief of pediatrics at Bellevue Hospital Center.
Lantos added that the hospital should have suspended Knight not just to potentially protect patients but to protect the hospital from lawsuits. If something were to go wrong with a patient now, the hospital "would just have to ask the family how many zeroes they wanted on the check," he said.
The experts said many hospitals fail to aggressively pursue red flags.
"Several hospitals like ours started changing back in the '90s, but across the board, medicine changes in a deliberate fashion, and sometimes it's not fast enough," said Dr. Gerald Hickson, senior vice president for quality, safety and risk prevention and professor of pediatrics at Vanderbilt University Medical Center.
Knight's arrest was first reported by The Miami Herald and Miami's Community Newspapers.
'It petrifies me'
Carricarte said she doesn't want to see her former boyfriend lose his job. She said she just wants what the experts recommended: for the hospital to suspend his privileges while it does an investigation.
She said she's disappointed that instead of suspending Knight, Nicklaus is publicly praising him.
In February, two months after his arrest, an article on the hospital's website entitled "Outpatient Success Story" described how, five months earlier, Knight had performed hernia surgeries on six siblings in one day.
Carricarte said that Knight's "platform" as a surgeon engenders a sense of trust among patients and their families. "It petrifies me," she said. "There's a discrepancy of power that's very easy to utilize."
Carricarte, an expert on suicide and depression, has appeared in various media outlets, including CNN.
Fox, Knight's attorney, said Carricarte isn't telling the truth.
Charles Pinto, a close friend of Knight's, testified that Carricarte told him Knight had access to her cameras because she feared for her safety, according to a deposition in the case obtained by CNN.
Pinto's girlfriend, Jasmine Kenna, who is also a friend of Knight's, testified that Carricarte was out to hurt Knight after they broke up, saying she wanted to "bury" her ex-boyfriend by having a member of her family use his business contacts to hurt the surgeon professionally.
"She's trying to ruin his life, and she's doing a damned good job," Fox said.
Fox added that Nicklaus Children's Hospital knows Knight better than the experts consulted by CNN and chose to let him keep practicing.
"The people in the best position to judge him are those who've worked with him for years and supervised him, and they obviously came to a different conclusion than the people you've spoken with," he said.
"He's never been in trouble; he's a veteran, a graduate of Yale University, an upstanding member of society and a very decent person all around."