Did Spine Surgeon Take Cellphone Pictures of Patient's Genitals?
Louis Kralick UNDER FIRE Louis Kralick, MD, is accused of sending images of an exposed patient to his wife.

A neurosurgeon in Alaska used his iPhone to take pictures of an anesthetized patient's genitals and sent the images to his wife and another person for "amusement and titillation," according to a lawsuit filed by the patient.

Louis Kralick, MD, allegedly pulled up the surgical drape and snapped images of the exposed 49-year-old male patient, who was undergoing spine surgery on Dec. 8, 2017, at Providence Alaska Medical Center in Anchorage.

A member of the medical center's staff contacted local police to report Dr. Kralick's alleged criminal activity. Members of the surgical team met with police, but the lawsuit accuses Dr. Kralick of refusing to cooperate with the investigation. Dr. Kralick deleted the unauthorized photos under the advice of the medical center's compliance officer, according to the lawsuit, which says the officer knew or should have known the images would be material evidence of the alleged crime.

"The police have seized Dr. Kralick's iPhone," says David Henderson, the patient's attorney. "But because he refuses to give them its password, they're locked out from seeing what's in it."

Mr. Henderson released a letter he says his client received from Dr. Kralick on Jan. 5. "Please consider this a letter of apology for inappropriate conduct on my part in the operating room," it reads. "While I did not intend my actions to be disrespectful, I can understand why some members of the operating room staff might have thought otherwise, and as a result I sincerely apologize."

"There's no excuse for this kind of behavior," says Mr. Henderson. "When patients are under general anesthesia, they're at their most vulnerable. They have to have confidence that doctors are going to act honorably, professionally and free of any immoral, perverted, or depraved motives or impulses. Suits such as this vindicate that expectation."

Mikal Canfield, a spokesman for the medical center, says in a statement that the facility launched an immediate investigation into the accusations levied against Dr. Kralick, realized the alleged breach in patient privacy could be a criminal act and contacted local law enforcement.

The lawsuit asserts multiple claims against Dr. Kralick including negligence, medical malpractice, deceit, tortious breach of confidentiality, invasion of privacy, intentional infliction of emotional distress, failure to obtain informed consent and destruction of evidence. The patient is seeking $100,000 in damages.

Dr. Kralick has not been charged with a crime. David Shoup, the attorney for Dr. Kralick, says in a statement the allegations against his client are "completely and utterly false."

Daniel Cook

Florida Nurse Arrested for Stealing Fentanyl
Burning Time DRUG DIVERSION Kirsten McDonough, 51, is charged with stealing fentanyl from a Florida surgery center.

When an anesthesiologist asked Kirsten McDonough, RN, for a vial of fentanyl, sometimes she would sign out for 2 vials, delivering 1 to the doctor and keeping 1 for herself.

Ms. McDonough got away with her game of one for you, one for me long enough to systemically steal 28 vials of fentanyl from the Merritt Island (Fla.) Surgery Center, say Brevard County police in announcing the 51-year-old nurse's arrest after a months-long investigation.

Police were called in after staff at the ASC became suspicious. An audit revealed the missing fentanyl and led to Ms. McDonough's arrest, the latest in a long line of drug diversion by surgical providers.

Ms. McDonough did not respond to a message left on her cell phone seeking comment.

Richard Abowitz

Patients: Plastic Surgeon Watched Porn and Used Drugs During Surgery
Risky Business DISTRACTED DOCTORING Dr. Haworth is accused of altering patient records and performing surgery while watching bizarre videos.

Watching pornographic and violent videos and using drugs while doing surgery are just a few of the accusations listed in a new complaint filed against a well-known Beverly Hills plastic surgeon, according to published reports.

Tess Broussard, a former patient, filed a lawsuit against Randal Haworth, MD, for medical malpractice concerning botched lip fillers in 2013, but the suit was thrown out when her expert witness couldn't testify, she told KTLA. In her new complaint, Ms. Broussard is citing a deposition of a consultant that worked for Dr. Haworth for 15 years.

The deposition, released in January, describes Dr. Haworth's bizarre operating room behavior such as watching pornographic and violent videos on a monitor in the operating room while performing surgery, says Ms. Broussard's attorney, Christopher Rudd. It also accuses Dr. Haworth of using Percocet unlawfully and having impacted vision after eye cancer treatment that could affect his ability to operate.

"She never would have hired the guy in the first place if she would've known these things," says Mr. Rudd.

Mr. Haworth's attorney, Matthew Oster, says the allegations are "outrageous and have no merit," in an emailed statement to Outpatient Surgery.

"They are based on reckless and uncorroborated claims made about him at a deposition by a disgruntled former employee who was terminated for fraud, conversion and participation in an unlawful prescription drug scheme," adds Mr. Oster. "We will vigorously defend against these false allegations and are examining all legal options against the individuals making these false claims."

JoEllen McBride, PhD

InstaPoll: Surgical Masks With Loops or Ties?

Some say surgical masks with ear loops aren't acceptable for use in the perioperative setting because they might not provide a secure facial fit that prevents venting at the sides of the mask. Tell us in this week's InstaPoll if you prefer loops or ties.

Hopes are high that smoke evacuation one day will become the law of the land, according to the 267 respondents to last week's poll.

Will smoke evacuation ever be the law of the land?

  • yes 82%
  • no 18%

Dan O'Connor

News & Notes
  • Gabapentin and opioids dangerous mixThe combination of opioids and gabapentin is associated with a 49% increase in the odds of opioid-related death, says a study in the journal PLOS Medicine. The researchers say the exact mechanism by which gabapentin increased the risk of death in opioid users is unknown, but is likely cause by a pharmacodynamic and pharmacokinetic interaction, and call for a reevaluation of the non-scheduled status of gabapentin at the federal level.
  • Why did hospital drop outpatient surgery program?A hospital system will end its outpatient surgery program because patients are going to several nearby freestanding ambulatory surgery centers instead of the system's 3 hospitals, says officials at the Faxton Campus of the Mohawk Valley Health System in Utica, N.Y. In one year, the number of outpatient procedures declined from 2,550 to 1,800 at Faxton Campus.
  • Total hip arthroplasty has more recovery complications than total knee Patients who had total hip arthroplasty (THA) are more likely to be readmitted to the hospital and require reoperation than those who had total knee arthroplasty (TKA). This according to an abstract posted by National Institute of Health of a study meant to examine readmission and short-term complications from these two surgeries. The study looked at 94,326 THAs and 147,160 TKAs, finding of 18 complications examined 7 had higher incidence in THA with 3 more common after TKA while the remaining 8 were similar in incidence in both surgeries. Overall the admission and reoperation rate for THA was higher than TKA.