Healthcare Standards

Deadline Detroit | Starkman: ‘Avoid Beaumont Like the Plague’ Warns Podiatrist Who Underwent a Colonoscopy at Royal Oak Hospital



The columnist, a Los Angeles freelancer, is a former Detroit News business reporter who blogs at Starkman Approved.


By Eric Starkman

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Ralph Zicherman, a Metro Detroit podiatrist who underwent a colonoscopy two weeks ago at Beaumont’s Royal Oak hospital, has some cautionary advice for anyone seeking medical treatment at the flagship campus of Michigan’s biggest hospital network: “Avoid Beaumont like the plague.”


“I am a podiatrist and have performed surgery for 40 years and was shocked by the treatment,” Zicherman said in a telephone interview. “The place was like a zoo.”


Zicherman said the anesthesiologist and the Certified Nurse Anesthetist (CRNA) who treated him were rushed and distracted when they spoke with him and never asked about his medical history or whether he had allergies.


Zicherman said that when he awoke from anesthesia, he wasn’t told that he’d been given Robinul, a mucus drying drug known to cause urinary retention. Zicherman said his chart is marked in red that he suffers from urinary retention because of a prostate condition he’s previously had surgery for at Beaumont.


The drug exacerbated Zicherman’s condition, making it impossible for him to urinate for 12 hours after his procedure. Zicherman said that he shouldn’t have been released from the hospital until it was certain he could urinate.


“I can’t tell you how much pain I was in that day,” Zicherman said. “What happened to me is a lapse of basic anesthesiology protocol.”

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Beaumont CEO John Fox


Zicherman said his Beaumont gastroenterologist, who he characterized as “excellent,” advised him to return to Beaumont for treatment but he chose to tough it out rather than further entrust his medical care to the hospital.


“I don’t know how (Beaumont CEO) John Fox goes home and sleeps at night,” Zicherman said. “He’s taken the best healthcare system in the area and transformed it into one people no longer have confidence in.”


Beaumont spokesman Mark Geary ignored a request for comment.


Zicherman was among the Beaumont patients who have contacted me in the wake of my stories last week about Richard Curbelo, a 51-year-old Beaumont Royal Oak patient who died on January 21 from a routine colonoscopy. Curbelo died from complications from an intubation, a procedure that industry experts say is rarely performed for a colonoscopy.


An anesthesiologist I spoke with Saturday afternoon said it’s also rare to use the drug Robinul during a colonoscopy. The anesthesiologist said Zicherman should have been advised the drug was given to him before sending him home but noted that many hospitals prefer to release patients as soon as possible and have them return if complications develop.

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Beaumont COO Carolyn Wilson


Beaumont Royal Oak is where the majority of surgical procedures at Michigan’s biggest hospital network are performed. Beginning January 1, Beaumont Royal Oak outsourced its anesthesiology and pain management services to Texas-based NorthStar Anesthesia. The cost cutting move, orchestrated by COO Carolyn Wilson, precipitated the exodus of about half of Royal Oak’s fellowship trained anesthesiologists, more than a dozen prominent surgeons, and about 50 CRNAs.


NorthStar in the healthcare industry is derisively known as “Death Star.” I reported last week the moniker likely referred to the space station in the Star Wars franchise capable of destroying an entire planet. A Beaumont employee, who asked not to be identified, contacted me to say the moniker refers to the quality-of-care NorthStar is associated with in the healthcare industry.


After Wilson announced the NorthStar contract, the co-heads of Beaumont Royal Oak’s nationally ranked cardiology department wrote a letter to Beaumont chairman John Lewis saying they had “serious concerns” about NorthStar’s ability to maintain Beaumont’s historical standards of anesthesiology care, previously among the highest in the healthcare industry.


CEO John Fox has maintained that 75 percent of Beaumont’s anesthesiologists joined NorthStar, a figure multiple sources dispute. He also has said that NorthStar’s replacements are as good or better than the anesthesiologists who quit rather than join NorthStar.


Sources within and familiar with Beaumont, as well as publicly available certification records, dispute this claim as well.

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Richard Curbelo


To fulfill Beaumont’s formidable surgery staffing requirements, NorthStar has been flying in anesthesiologists from around the country or temporary relocating doctors from its other Detroit-area hospitals, none of which do even close to the volume or complexity of Beaumont’s surgical business. News of Curbelo’s death undergoing a colonoscopy has gone viral, and multiple anesthesiology experts have contacted me to say that relying heavily on temporary anesthesiology staff puts patient safety at risk.


The anesthesiologist who tended to Curbelo was visiting from another Detroit-area hospital and the CRNA was from Beaumont Dearborn.


Touting Credentials


Dr. Romeo Kaddoum


NorthStar has touted the credentials of Romeo Kaddoum, the company’s regional chief medical officer for the Detroit area, noting he has completed anesthesiology residencies at American University of Beirut and Detroit Medical Center/Wayne State University. The company also noted that Kaddoum completed a fellowship in adult cardiac anesthesiology from Johns Hopkins.


However, Kaddoum isn’t echocardiography certified, a critical tool for diagnosing suspected cardiac disease. The certification was required of all Beaumont cardiac anesthesiologists prior to NorthStar taking over.


NorthStar notes that Kaddoum’s brother Roland, who is visiting from Beirut and working at Beaumont Royal Oak, is board certified in anesthesiology and pediatric fellowship trained. He completed his residency at Wayne State University and pediatric fellowship at Children’s Hospital of Michigan. In addition, he was a member of the Anesthesia Department at St Jude Children’s Research Hospital in Memphis from 2008 until 2011.


NorthStar says Roland Kaddoum has been published in 40 peer-reviewed international journals including Anesthesiology, Anesthesia & Analgesia, Canadian Journal of Anesthesiology, and Pediatric Anesthesia. However, Roland Kaddoum isn’t board certified  in pediatric anesthesiology, a requirement that Beaumont previously demanded of its frontline pediatric anesthesiologists.


As it’s been explained to me, being fellowship trained but not certified in the specialty is akin to taking a driver’s ed course but not going through with getting a license.


NorthStar has repeatedly maintained that all its anesthesiologists adhere to Beaumont’s historically rigorous credentialing standards. However, given the high number of anesthesiologists parading through Beaumont Royal Oak on a temporary basis, there’s been widespread speculation that Beaumont’s chief medical officer David Wood Jr. has granted temporary hospital privileges to accommodate NorthStar’s reliance on outside medical staff.


Asked about NorthStar relying on temporary privileges, spokeswoman Elizabeth Squire issued this statement: “Beaumont does have a high standard and thorough process for both temporary (different from emergency) and permanent credentialing, and every NorthStar anesthesiologist currently practicing has gone through that process. Therefore, every new NorthStar anesthesiologist has been carefully vetted, reviewed, and approved to ensure they meet Beaumont’s high standards and expectations.”


Beaumont’s medical staff remain unimpressed with the NorthStar replacements, insisting there are a higher number of incidents endangering patient care, including a patient receiving the wrong dose of lidocaine pain medicine that could have caused a seizure or death. I’m told that Michael McCue, Beaumont Royal Oak’s interim chief of anesthesiology, recently chastised one of NorthStar’s temps for signing off on patient charts without actually seeing the patients.


Zicherman, the podiatrist who warned about staying away from Beaumont, said the difference in quality of care since NorthStar took over is readily apparent. Zicherman underwent surgery at Beaumont a year ago and said the standards and professionalism of the anesthesiology staff was “as different as night and day.”


Reach Eric Starkman at eric@starkmanapproved.com. Beaumont employees and vendors are encouraged to reach out, with confidentiality assured.


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