At its meeting on Dec. 8, 2012, the Board of Directors of the American Association of Orthopaedic Surgeons (AAOS) considered a grievance filed under the AAOS Professional Compliance Program. After considering the information presented and upon recommendation of the Grievance Hearing Panel of the Committee on Professionalism, the Board took the following professional compliance action.

Manuel A. Martinez, MD
Westlake, Ohio
Censure
On Feb. 16, 2012, a grievance was filed against Manuel A. Martinez, MD, alleging violations of the Standards of Professionalism for Orthopaedic Expert Opinion and Testimony, Mandatory Standards Nos. 1 (“An orthopaedic surgeon shall not knowingly provide oral or written medical testimony or expert medical opinions that are false.”) and 6 (“An orthopaedic surgeon who provides oral or written medical testimony or expert medical opinions shall seek and review all pertinent medical records and applicable legal documents, including relevant prior depositions, before rendering any statement or opinion on the medical or surgical management of the patient.”).

The grievance arose from statements made by Dr. Martinez in his Affidavit of Merit as an expert witness for the plaintiff in a medical liability lawsuit. The plaintiff-patient alleged that the surgeon failed to meet the standard of care in obtaining informed consent and performed inappropriate and overly aggressive surgery. As a result, the plaintiff-patient alleged she suffered from residual scarring, severe pain, and sustained limited use of her left hand. The lawsuit was dismissed by the trial court.

The patient in the underlying case was diagnosed with a tear of the triangular fibrocartilage complex (TFCC), which resulted in a resection of the torn TFCC performed by the Grievant. The surgery was uneventful, but the patient complained of ongoing pain in the left wrist. A subsequent arthrogram revealed a central defect in the TFCC, and the patient underwent an ulnar shortening osteotomy two months later performed by another surgeon.

The opinion of a general orthopaedist was needed for this case, and Dr. Martinez was asked by a colleague, and subsequently by the plaintiff’s attorney, to review the case and provide his opinion. Dr. Martinez had been briefed about the specifics of the case through phone conversations with the plaintiff’s attorney and discussions with his colleague. Dr. Martinez was asked by the plaintiff’s attorney’s office to sign the Affidavit so that the office could release a copy of the files discussed.

Dr. Martinez signed the Affidavit of Merit on April 5, 2011; however, he did not receive a copy of the medical records and file until the next day (April 6). At the time he signed the Affidavit of Merit, it was Dr. Martinez’s understanding that this was a communication between counsel and himself; that it would not be used until he completed a full review and gave his written opinion; and that he would have the opportunity to amend his opinion if subsequently provided with additional information. However, the content of the Affidavit of Merit would reveal that it was not a request for release of medical records, but an attestation to a breach of the standard of care.

On July 20, 2012, the Committee on Professionalism (COP) conducted a hearing at which the Respondent, Dr. Martinez, was present. The Grievant did not attend or provide a written statement in lieu of his appearance.

After an in-depth evaluation of the facts presented, all materials submitted, and the Respondent’s oral testimony at the hearing, the COP Grievance Hearing Panel found that Dr. Martinez violated Mandatory Standard No. 1 by signing an Affidavit of Merit that stated that he had reviewed all of the medical records supplied to him by the plaintiff’s law firm, when he admittedly had not personally reviewed the medical records. The Panel found that Dr. Martinez was parsing his words by referring to the Affidavit, fax, and his telephone notes as the applicable records, and not the actual patient medical records.

The Panel also found that Dr. Martinez violated Mandatory Standard No. 6 by signing an Affidavit of Merit that affirmed a breach of the standard of care without first reviewing any pertinent medical records. The COP Grievance Hearing Panel recommended that Dr. Martinez be officially censured by the AAOS.

Dr. Martinez did not appeal the COP Report and Recommendation and, on Dec. 8, 2012, the AAOS Board of Directors considered this matter. After due deliberation, the Board upheld the findings and recommendation of the COP Grievance Hearing Panel and voted to censure Manuel A. Martinez, MD, due to unprofessional conduct in the performance of expert witness testimony.

Additional Professional Compliance Actions
At its meeting on Dec. 8, 2012, the AAOS Board of Directors also considered the following compliance matters not related to the AAOS Standards of Professionalism and took the actions indicated.

Bill Alexander, MD
Fort Worth, Texas
Expelled
In June 2012, the Office of Diversion Control, U.S. Drug Enforcement Administration (DEA) issued a Decision and Order that denied Dr. Alexander’s Certificate of Registration to dispense narcotics. This action was based on the DEA’s investigation and findings of Dr. Alexander’s misconduct in issuing prescriptions without the requisite state authority, his admitted transportation of narcotics for a drug trafficking organization, and his self-abuse of a controlled substance.

The AAOS Board of Directors voted to expel Dr. Alexander.

Michael Baghdoian, MD
Grosse Ile, Mich.
Fellowship Suspended
In February 2012, the State of Michigan Board of Medicine Disciplinary Subcommittee issued a Final Order wherein Dr. Baghdoian was fined and reprimanded, and his medical license was placed on probation for one year based on his failure to meet continuing medical education (CME) requirements. The terms of his probation include completion of an additional 41.5 hours of CME within the probation term.

The AAOS Board of Directors voted to suspend Dr. Baghdoian’s Fellowship in AAOS until such time he has a full and unrestricted medical license.

For more information on the AAOS Professional Compliance Program, visit www.aaos.org/profcomp