Look up the Wisconsin medical license for John Kidd, MD.
All that is posted is a because he had moved to New York and didn't plan to practice again in the state.
Look up Kidd's license in New York and there is no indication of any allegations of poor care or wrongdoing against him there -- or anywhere else in the country.
But, documents obtained by the Milwaukee Journal Sentinel, USA Today, and 乌鸦传媒 offer a different picture.
They show Kidd was terminated in 2010 by his employer, a business that provides anesthesiology services for Theda Clark Regional Medical Center in Neenah, Wis., after a series of alleged incidents earlier that year:
- When a patient had trouble breathing, Kidd would not help a nurse and doctor who had rushed to the patient's aid.
- When a patient who was having a limb amputated complained of pain and discomfort, Kidd was on his cellphone and did not respond promptly.
- A nurse thought he was once impaired at work and smelled of alcohol.
An investigator with the state Department of Safety and Professional Services wanted to reprimand Kidd, saying discipline was needed because of the potential risk of harm to other patients.
However, after an 18-month battle with Kidd's attorneys, there was no reprimand.
Instead, Kidd agreed to surrender his license and not reapply for it, a step some doctors take to avoid a blemish on their public record.
Kidd, 53, is one of more than 250 doctors who surrendered their medical license since 2012, but who were still able to practice in another state, an investigation by the news organizations found.
To learn what prompted the license surrender, the news organizations sought access to all of the documents in the Wisconsin medical board's file on Kidd. The board blocked access to documents that included personal health information, mental health evaluations, or anything the board deemed the work product of its attorneys.
Still, the request resulted in the release of nearly 200 pages of documents -- investigative memos, letters from lawyers, reports from outside doctors, transcripts of interviews with nurses, and a competence assessment of Kidd done by an outside firm.
The records provide a rare window into the nation's broken system of doctor discipline.
They show a medical board hamstrung by arcane matters, including what it can afford to pay an expert to evaluate Kidd's work, and a doctor's lawyers willing to contest key points, in hopes of landing a better outcome.
Investigation begins
The matter began in December 2010, when the state received a five-page letter from Kidd's former employer, an Appleton, Wis.-based group of doctors known as the Association of Hospital Anesthesiologists. He had been terminated on Nov. 5, 2010.
"The concern is that Dr. Kidd has not maintained the vigilance necessary to practice anesthesia in the Group's practice," wrote Karl Orth, MD, president of the group.
"The Group cannot say whether Dr. Kidd might be able to practice without concern in a different setting. Thus, as a precautionary matter, the Group has decided to report this matter to the Medical Examining Board."
The first step was for the medical board to conduct its own investigation of the complaint.
Early on, it was clear that state investigators believed a reprimand was needed.
In a February 2011 memo placed in the case file, investigator Kelley Sankbeil detailed additional allegations described by the group: Kidd arrived late for procedures, he put patients to sleep without required oxygenation levels, he did not administer narcotics during surgeries, which resulted in patients awakening with pain, and he turned off monitor alarms in the operating room.
Sankbeil turned to an outside doctor, James Conterato, MD, an anesthesiologist then at the Marshfield Clinic. In a July 2011 memo, which summed up an interview with Conterato, Sankbeil wrote that the patient who was having trouble breathing would have died if nurses and another doctor had not interceded when Kidd did not.
"Dr. Conterato stated Dr. Kidd put the public at risk and was clearly negligent," Sankbeil wrote.
The patient died several days later due to an anticoagulant drug that caused bleeding in the brain. Kidd did not cause his death, Conterato said.
In an October 2011 email to Conterato, medical board attorney Kim Kluck said Kidd's attorney was not willing to accept a proposed settlement: A reprimand and putting the doctor into a monitoring program.
"His lawyer thinks that this should be an Administrative Warning and feels Dr. Kidd got 'voted off the island' at this anesthesiology group, because some surgical nurse did not like him," Kluck wrote. "I disagree with him in both regards."
Typically, such a reprimand would have publicly spelled out what led to that disciplinary action.
The battle went on.
In December, the board sought an expert opinion from another anesthesiologist, Brent Shulman, MD, at St. Joseph's Hospital in Marshfield, Wis., but told him that they could only afford to pay him $75 an hour because of "budgetary constraints." At the time, the annual budget of the medical examiner board was $1.8 million.
It's unclear if that evaluation took place, and nothing more was included in the documents provided in response to the open records request.
However, seven months later Kluck wrote a letter to Timothy Swan, MD, another doctor at the Marshfield Clinic, saying he had been assigned as a new case adviser. The medical board has a list of doctors who have agreed to help in such cases.
It is unclear whether Swan provided an opinion.
Lawyers for Kidd make their case
Kidd's attorneys countered with their own expert -- Neil Tabakin, MD, of Milwaukee.
In April 2012, Tabakin wrote a seven-page letter that concluded Kidd met the standard of care in his treatment of the patient. That letter was sent by Kidd's attorney, Barbara Zabawa, to the medical board in an effort to argue for lesser action.
In her own letter, Zabawa emphasized Kidd's history of helping patients.
Kidd got his medical degree from the University of Wisconsin School of Medicine and Public Health in 1992. After completing a residency program in anesthesia at Oregon Health and Science University in Portland, Kidd joined the anesthesiology group in Appleton and began practicing at Theda Clark in 1998.
"During those 12 years (until he was terminated in 2010) he worked full-time, including nights and weekends," Zabawa said. "He practiced in a wide spectrum of cases from crash [emergency] C-sections to hemorrhaging trauma patients to delicate intracranial procedures."
She wrote that Kidd had delivered anesthetics as many as 20,000 times -- all without a reprimand or malpractice complaint -- and noted he had just been appointed chairman of the department of anesthesia by his new employer in New York.
"Doctor Kidd is an esteemed and admired practitioner of anesthesia," Zabawa wrote. "It's easy to criticize methods and decisions in hindsight."
Based on the documents provided by the board, it is unclear what additional discussions took place between the two sides. There is a gap of a few weeks within the records provided.
On June 1, 2012, Kidd's attorney, Zabawa, wrote Kluck, the board attorney, about setting up an informal settlement conference on July 23. A separate document, dated June 6, indicated the parties were "in the process to negotiate a settlement."
The next document is a July 5 agreement signed by Zabawa, Kluck, and Kidd in which Kidd agrees to resolve the case and give up his right to a hearing. He neither admits nor denies the allegations in the case. No mention is made of a reprimand.
Two weeks later a board order in which Kidd voluntarily relinquishes his license was issued.
Agreement "satisfied the board's goal"
Kidd was granted a New York license in September 2011, 10 months after he was terminated from his job with the Wisconsin anesthesiology group.
Kidd, who now practices at the Adirondack Medical Center in Saranac, N.Y., did not respond to efforts to reach him through his attorney and at the medical center.
Matt Censky, a spokesman for the Wisconsin board, noted that the board secured a permanent surrender of Kidd's license, while avoiding costly litigation that might have resulted in him being able to keep practicing in Wisconsin.
A legal battle over a reprimand would have had an uncertain outcome, especially if an administrative law judge found that Kidd's expert witness was more credible than the state's, Censky wrote in an email:
"The surrender provided a certain outcome and more than satisfied the board's goal of protecting the public."
John Fauber is a reporter for the Milwaukee Journal Sentinel and 乌鸦传媒.
This story was reported as a joint project of the Journal Sentinel and 乌鸦传媒.