Inside a secret report
Brain surgeon's care outlined patient by patient
Rachel Brand, Rocky Mountain News
Published November 4, 2003 at midnight
Conflict swirled around Dr. Issam Awad from almost the moment he arrived in January 2001 as chairman of the neurosurgery department at the University of Colorado School of Medicine.
And by this past summer, after more than a year of warnings, the neurosurgery residency program at CU was put on probation by a national accrediting panel because of conflicts with Awad in the department and other issues.
By July 2002, four senior neurosurgeons at CU - Drs. Robert Breeze, Glenn Kindt, Kevin Lillehei and Ken Winston - had complained in writing to the University Hospital medical board about the quality of Awad's care and his ethics - complaints Awad says were malicious and false.
The board appointed a five-doctor investigative committee that examined 10 of Awad's cases identified by the neurosurgeons. The board temporarily suspended Awad's hospital privileges in November 2002 at the committee's recommendation while its investigation continued.
The committee's secret final report, presented Jan. 21, recommended permanently revoking Awad's hospital privileges, according to a copy of the report sent anonymously to the Rocky Mountain News.
The committee's findings were published Saturday in the News after University Hospital unsuccessfully went to court to stop publication. The committee concluded that Awad gave substandard care in seven of the cases and committed "egregious" breaches of ethics.
Four days after receiving the report, the medical board reinstated Awad's privileges, and an e-mail a few weeks later by CU School of Medicine Dean Richard Krugman told faculty and staff that Awad was "completely exonerated by the hospital," but was resigning as chairman because of unmanageable conflict. Awad said he had presented the board with 14 experts' testimony and a boxful of data in his defense 10 days earlier.
Awad denies the allegations and says the report was biased and the peer review process was corrupted by his accusers and the committee's bad-faith investigation. He has sued the hospital, the university, the four neurosurgeons and chief resident Sean Markey, claiming discrimination and harassment because he is Lebanese.
He says - as do the hospital and CU - that the confidentiality of peer review prevents him from discussing it. But his lawyer, Paul Hultin, gave written responses to questions from the News and supplied comments on six patients who signed waivers releasing Awad from patient privacy laws. Some patients' stories were reported Monday; the rest are presented today.
Awad, who recently took a position with a hospital affiliated with Northwestern University, said he wants to discuss the peer review process to defend himself fully. The News has filed a motion in his suit requesting the judge remove a seal of secrecy on his allegations about the peer review process.
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