Doctor Fired After Revealing Testing Flaws

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MILWAUKEE -- A cardiologist whose research at a national medical meeting revealed that other doctors at her hospital were misreading a substantial number of diagnostic echocardiograms has been fired by that hospital, the Journal Sentinel and MedPage Today have learned.

The fired physician, Dr. Kiran Sagar, said she was called into a meeting with Aurora St. Luke's Medical Center officials at the end of August -- two months after the results of her study were presented at the American Society of Echocardiography meeting -- and told that her contract was being terminated.

Sagar said she was told she would be paid until the end of November, but she had to leave her hospital office immediately.

Read this story on www.medpagetoday.com.

"They said, 'Don't worry, we'll pack up your office,'" Sagar said.

In an interview, she said she was never told why she was being let go. She said she suspects it was because of her research on the misread echocardiograms and the publicity it generated.

"The cardiologists weren't happy," she said. "I think behind the scenes they were saying, 'How can you expose our dirty laundry?'"

In an e-mail, an Aurora spokesman said Sagar's firing was not related to her presentation.

"Dr. Sagar's contract was terminated for a number of reasons, none related to her study," spokesman Adam Beeson said in the statement. "This was in no way a retaliatory action. As a matter of fact, the study supported our quality improvement initiatives and has resulted in heightened standards in the echo lab."

Sagar, 65, who has trained dozens of doctors in echocardiography over the years, is one of the first female cardiologists to practice in Wisconsin.

She came to Aurora in 2003 after leaving a tenured position at the Medical College of Wisconsin.

"Is she a good doctor?" said Dr. Alfred Tector, a long-time St. Luke's heart surgeon. "Yes, she is. She has a very good reputation."

However, Sagar said she now is unable to practice medicine in the area because of a noncompete clause in her contract that prohibits her from working as a doctor within 20 miles for two years.

"I'm a physician and I have no options," she said. "What can I do? I have to move."

Exposing Errors

The study reported at the ASE meeting involved a review of 235 echocardiograms done at St. Luke's from August 2007 to October 2008.

All physicians who interpret heart ultrasounds are required to have a minimum of six months of training during their fellowship; the highest level of training, Level 3, requires a minimum of 12 months of cardiac ultrasound training in an accredited fellowship.

Of the 35 physicians who performed clinical readings of the echocardiograms reviewed in the study, only three were Level 3 specialists within cardiology.

Sagar's analysis revealed that 68 of the 235 imaging studies, or 29 percent, were misread.

In at least five of those cases, patients actually went into the operating room with a faulty diagnosis, although the problem was discovered before surgery was done.

In addition, 18 patients were subjected to more invasive echocardiography in which a probe was inserted down the throat and 19 underwent invasive coronary angiography. The misreadings also resulted in increased healthcare costs for the patients.

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