The Greenwich (Conn.) Hospital is facing a pair of lawsuits from patients who didn't know their plastic surgeon was a drug addict who'd been in and out of rehab clinics for nearly a decade.

In the most recent case, filed in December, patient Diane Buchanan accuses the hospital of negligence on grounds that administrators reportedly knew since 1997 that Ian Rubins, MD, had a history of drug use but didn't disclose this to patients.

A class action lawsuit filed by 8 other patients in October 2008 also alleges that the hospital knew of Dr. Rubins's addiction but didn't make it public until 2007, when a hospital spokesperson mentioned in a newspaper article following the suspension of his privileges at the hospital and his surrendering of his medical license.

"The hospital let a known drug addict operate on Diane, and he did a substandard procedure due to his addiction problems," attorney Carey Reilly, JD, told Outpatient Surgery Magazine. After breast surgery with Dr. Rubins in 2006, Ms. Buchanan suffered nipple necrosis, a Staphylococcus infection, and poor wound healing that required 4 revision reconstruction surgeries, say court documents.

Dr. Rubins died in January 2008 after overdosing on heroin and cocaine. He had generated a record of drug-related incidents, including stays in inpatient rehab in 1996 and 2006.

In April 2006, he was seen nodding off while standing in a break room between cases. Later, while filling a urine sample under supervision, he dropped the vial in the toilet, went to his car for a bottle of water, and produced a urine sample that investigators noted was not the same temperature as a fresh one. In May 2007, he injected himself with fentanyl that had been prepared for another surgeon's patient and refilled it with saline solution, according to a press report.

In an e-mail, Greenwich Hospital attorney George Pawlush said that the hospital could not comment on the case during litigation.

Kent Steinriede

Computer sleuths are hot on the trails of 2 anonymous Web-based attackers who lashed out at healthcare providers last fall.

The first case involves Fort Wright, Ky., plastic surgeon Jean M. Loftus, MD. An anonymous individual posted negative comments about her skills and the book she authored on 2 Web sites.

According to the suit filed by Dr. Loftus, on one site, the poster wrote: "Do not go to this doctor. She claims to be an expert and in my opinion is mediocre at best. I went to another cosmetic surgeon that said her work was not good at all. We discussed what she was supposed to do extensively before my surgery and she ended up doing what she wanted to do. The results were horrible. She states she [sic] on her web site that her practice is world renknown [sic]; don't let that fool you, it is not her skill but merely the fact she has sold her books over seas. I have learned a valuable lesson, just because someone writes a book, it does not make them a skilled surgeon."

On another, the same poster wrote about Dr. Loftus's book "The Smart Woman's Guide to Plastic Surgery," "Okay since I bought this book because of all the 5 star reviews it got here I'd like to send others a warning. This is NOT a 5 star book!!!!!!!!!!!! I feel foolish having wasted my money on this. Oh yeah and add insult to injury, you can go to the author's website and get the same exact information plus colored photos as opposed to black/white found in the book. Anyone considering plastic surgery shouldn't bother with this book. You will get the same exact information in a consultation with a plastic surgeon or off numerous sites on the internet. DO NOT BOTHER!!! Sure wish I was warned."

Dr. Loftus alleges that the statements are defamatory and designed to deter patients from choosing her and physicians from referring to her.

At Dr. Loftus's request, the U.S. District Court of Eastern Kentucky subpoenaed Amazon.com and MDX Medical, LLC. Dr. Loftus seeks actual and punitive damages.

In another case, Philadelphia-based Albert Einstein Healthcare has sued an individual known only as ttruthseeker999@aol.com, charging that the individual illicitly gained access to e-mails of a managerial employee. Ttruthseeker999 harvested confidential personnel information from the emails and sent the information to other Einstein employees. Einstein says the IP addresses of the computer that hacked its system and the one that sent the emails are identical.

Einstein is charging ttruthseeker999 with violation of the Computer Fraud and Abuse Act.

On January 13, the U.S. District Court for the Eastern District of Pennsylvania agreed to subpoena Verizon to discover ttruthseeker999's true identity. The case is pending.

Dan O'Connor

Don't let misconceptions about single-use device reprocessing stop you from considering a process that reduces healthcare waste, benefits the environment and saves facilities thousands of dollars, implores a commentary appearing in the March issue of the journal Academic Medicine.

"These devices are safe, but it's a public relations challenge," says surgeon Martin Makary, MD, MPH, an associate professor of public health at the Johns Hopkins University School of Medicine in Baltimore and the article's lead author. "Reprocessed devices are as good as new since the testing standards for reuse are impeccable and there have been no patient safety problems in our analysis."

The authors allay concerns over patient safety by highlighting the Medical Device User Fee and Modernization Act of 2002, which requires the labeling of all reprocessed SUDs and the identification of the reprocessor. In addition, they cite the January 2008 Government Accountability Office report that notes "reprocessed SUDs do not present an increased health risk when compared with new, non-reprocessed devices."

For facilities interested in SUD reprocessing, the authors suggest reviewing the FDA's Web page on the subject and working with FDA-registered third-party reprocessors that offer factory site visits, exhaustive testing and adequate liability insurance coverage.

Daniel Cook

How quickly can your staff turn a room over (which we'll define as the time between one patient's leaving the OR suite and the next one's arriving)? Tell us your average time in this week's online poll. We'll report the results in this space next week.

Three-fourths (75%) of the 252 respondents to last week's poll say they let patients undergoing eye surgeries wear their street clothes in the OR. "This is pretty much the picture I had expected to see," says Ann Marie Pettis, RN, BSN, CIC, director of infection prevention at the University of Rochester Medical Center in Rochester, N.Y.

While our survey didn't track whether respondents worked in ambulatory surgery centers or hospitals, Ms. Pettis speculates that ASCs are much more likely to let their patients into the OR without changing clothes than hospitals are.

Dan O'Connor