Why Wasn't He Stopped Sooner?

Hospitals are required to report to their state medical board and NPDB any revocation, suspension or restriction of a doctor's clinical privileges for more than 30 days. But hospitals don't always comply. By the end of 2001, 55% of all nonfederal hospitals registered with the NPDB had not reported a single disciplinary action against a doctor. (Two Kaiser administrators paid nearly $20,000 to settle with the state after failing to report McEnany, and the medical center says reporting procedures "are definitely different now.")

Hospitals face many incentives not to report a disciplined doctor--and not to discipline him at all. A hospital may want to limit its liability by not airing the problem. Or it may be afraid of a legal battle with the physician. And doctors are loath to report a colleague's bad behavior. Consumer advocates say that self-policing by doctors and hospitals is not sufficient and that patients need access to state medical board and NPDB records that are denied to them today.

That's why Raymond Hilson didn't know about the $200,000 settlement that Kaiser paid in 1992 to Richard Lord and his family for the loss of his wife Eleanor, who, according to the California investigation, bled to death while in McEnany's care. If Hilson had known more, he says, he would have gone elsewhere. Learning the surgeon's history has made him see things in a different light. Strange as it may sound, he says, "I feel lucky to be a survivor." --By Leslie Berestein/Los Angeles