By Dr. Tony Tannoury was fined $5,000 for leaving one of his patients on the operating table while he ducked out to take a nap. Despite the fallout, he is allowed to keep working.
However, his critics say this is just a light slap on the wrist and that the punishment should be more severe.
Out to Lunch
Tannoury, 54, head of spine surgery at Boston Medical Center, has worked at the facility since 2006. He specializes in minimally invasive procedures and promises not to prescribe “any treatment that I would not, or have not, used on my immediate family members and closest friends,” according to his practice’s website.
The incident in question occurred on November 22, 2016. The patient came to BMC in need of emergency ankle surgery. Tannoury and the chief resident at the time took the patient into the OR at around 9:30 pm.
According to the consent order, Tannoury “left the OR when the patient was being prepped for surgery and before the surgery began, intending to get something to eat prior to performing the surgery.” He left the hospital, “bought something to eat in his parked car, and fell asleep in the vehicle.”
When he woke up a few hours later, Tannoury called the hospital and was told that the chief resident performed the surgery that he missed. The surgery was ultimately a success, despite Tannoury’s absence. He didn’t return to the hospital until the next day, according to the Massachusetts Board of Registration in Medicine.
Two months later, the hospital reported the incident to the state medical board, which led to an investigation.
The board found that Tannoury “engaged in conduct that undermines the public confidence in the integrity of the medical profession.”
In addition to the fine, he was ordered to complete five continuing education credits in “professionalism” and review regulations for supervising residents.
The results of the investigation weren’t made public until last Monday, nearly five years after the incident first occurred.
Tannoury also received a written reprimand from the hospital for violating its policy that surgeons be present for critical parts of operations. Federal law also requires surgeons at teaching hospitals to be present during surgeries in order to bill Medicare for the procedure.
BMC spokeswoman Jenny Eriksen Leary said the hospital was “fully transparent with the patient regarding the situation and who conducted the operation.” She added, “The surgical outcome was positive,” and that the hospital waived all fees related to their care.
Too Little Too Late?
George Zachos, the medical board’s executive director, says there were a number of reasons why it took the board over four years to discipline Tannoury. He says the board has the burden to prove a physician violated regulations or the law by a “preponderance of evidence.”
Dr. James Rickert, president of the Society for Patient Centered Orthopedics, blasted the board’s decision. He’s known for criticizing surgeons that don’t tell their patients they might not perform key aspects of the operation.
“That’s just the proverbial slap on the wrist,” said Rickert. “I can’t believe that if that was a board composed mostly of patients that they wouldn’t have had a much harsher penalty.” Four of the five members of the state board are physicians, according to the board’s website.
Rickert says more patients should serve on medical boards, so that providers like Tannoury don’t get off scot-free when these kinds of incidents arise.
This also isn’t the first time Tannoury has been disciplined for his behavior.
A sweeping 2015 report from the Boston Globe found that a handful of surgeons at Massachusetts General Hospital were juggling multiple procedures at the same time without informing patients. The report led to a national debate over what’s known as double-booking procedures.
Reporters said Tannoury would often oversee two operating rooms at once with the procedures overlapping by several hours.
Leary added that the facility updated its policies in 2015 – before the ankle surgery mishap – to ban surgeons from running more than OR at the same time.
The latest debacle strikes a familiar chord in the Massachusetts healthcare industry.
In 2002, Dr. David Arndt, a physician at Mount Auburn Hospital in Cambridge, walked out on a patient in the middle of a complicated spinal surgery to cash his paycheck. The patient was left lying on the operating room table and anesthetized with an open incision. Arndt was dealing with a drug problem at the time. He ended up losing his medical license and facing a slew of criminal charges.
In 2019, the state medical board tightened regulations for surgeons who leave the OR before the procedure ends. It’s true that many surgeons will oversee multiple ORs at once in teaching hospitals, but the procedures usually overlap by just a few minutes. For example, they will usually leave while the trainee closes the wound as they go off to start the second procedure.
The new regulations state that providers must give detailed information to the patient in terms of who will be performing the operation. They also require hospitals to document each time a lead surgeon enters and leaves the operating room.
