California governor and medical board should stand accused in patient’s death

UPDATE: Rutland will be allowed to continue practicing but cannot perform surgeries or deliveries after a judge's Jan. 7 decision. Here's the Orange County Register story.

When Maurice Clemmons shot a police officer outside Seattle last year, former Arkansas Gov. Mike Huckabee was criticized for paroling Clemmons 10 years into a 108-year sentence.

When obstetrician-gynecologist Dr. Andrew Rutland was accused this week of killing again in California, nobody called Gov. Arnold Schwarzenegger. Nobody called the governor's appointees on the Medical Board of California, either, and they are the ones who are ultimately responsible, along with Rutland himself.

Starting in the fall of 2001, I reported on and wrote about Rutland as part of a team of reporters at The Orange County Register for the better part of a year. The resulting investigation, "Doctors without Discipline," was published in April 2002. In it, we used Rutland as the central example of how the Medical Board of California had failed to uphold its duty to protect patients from dangerous doctors. (My editor on that project, Mark Katches, wrote his interesting take on Rutland for CalWatch, where he is editorial director.)

Rutland's record was appalling. He had been sued repeatedly by patients for unnecessary surgeries, injuries and deaths. And patients had complained to the medical board, too. He was investigated twice, in 1994 and 1996, but the board did nothing more than require him to take some classes. We wrote in the Register:

He attended a half-day course April 24, 1999, at the San Diego PACE program, which he barely passed, according to documents obtained by the Register. Evaluators noted some concern that "he was quite fond of quoting the 1970s' USC literature."

Two years later, he used forceps to yank and twist a baby girl, Jillian Broussard, out of her mother's womb. The pediatric neurosurgeon who tried to save her life told me later that her spine had looked like a frayed rope.

California has a cap on malpractice judgments, and so finding a good lawyer to take a case can be tough. The Broussards were one of the few patients who won their case against Rutland. They had a good lawyer. And they had Rutland on videotape.

I approached them carefully, and, I hope, respectfully. I knew that they really didn't have much to gain by talking with a reporter. They had lost their daughter, and nothing would change that fact. But they thought they were just an isolated case, a bad mistake made worse by Rutland trying to blame Jillian, saying she had suffered a stroke and there was nothing he could have done. I told them about the other cases, including a baby who had died two years before Jillian in Rutland's care.

The Broussards also didn't realize how many people along the way could have taken steps to keep Rutland from doing more harm. This paragraph from that story still chills me:

After baby Jillian Broussard died at the former Martin Luther Hospital in Anaheim, Dr. Janis Fee, then the hospital's obstetrics chairwoman, recommended that Rutland's hospital privileges be suspended and a report be filed with the board. But a lawyer for the hospital suggested that Rutland be allowed to continue practicing, with a supervisor. The lawyer wanted "to avoid potential litigation against the hospital by Dr. Rutland," Fee wrote in a declaration to the board. Rutland was not disciplined. A report was never filed.

Instead, Rutland kept on practicing. It wasn't until 2002, after the Register stories and after Rutland injured another baby that the board finally suspended his license. Eventually, he voluntarily gave his license up.

The Broussards were incredibly brave and agreed to testify at a state legislative hearing before a committee that was deciding whether the board should be, or even could be, reformed. The committee's recommendations eventually resulted in the board's policies being revamped and new members being appointed to the board who were not physicians and would make the board less of a fox guarding the henhouse.

Of course, as a reporter, I like to think the state assembly and senate and governor acted because of The Orange County Register's stories. But I don't think it would have happened without the Broussards' testimony.

Rutland sued the Register and took the unusual step of suing some of his former patients. He represented himself, and the case was thrown out.

Five years later, when Rutland petitioned to have his license reinstated, the Broussards were brave enough again to call for his petition to be denied. But the board ignored the very people they had failed to protect. The board gave him his license back.

On Christmas Eve 2009, the board once again filed charges against Rutland.

Rutland is now accused of negligence in the case of a woman who died during an abortion. A 30-year-old patient died in 2009 after Rutland gave her the wrong dose of anesthesia in an unlicensed, back alley office, the medical board says. As is often the case with doctors working on the fringe, Rutland had found a niche with immigrants. The woman did not speak English and had to use a Chinese translator, according to the medical board.  

The Register's Courtney Perkes wrote:

An unidentified woman visited Rutland's San Gabriel clinic in July for a second-trimester abortion. He injected lidocaine, a local anesthetic, in her cervix. Shortly afterward, the patient began to have a reaction, documents say.

Rutland, 66, performed CPR. The board documents say there was a "significant delay" in calling 911. When paramedics arrived, the woman was in cardiac arrest. She was taken to a hospital where she died six days later. An autopsy concluded that her heart attack was caused by "lidocaine toxicity," board documents say.

The board alleges that Rutland gave her the anesthetic "without knowledge of the safe dosage range or maximum safe dose." The documents say he also failed to recognize the signs of toxicity or provide appropriate resuscitation efforts.

Once again, it is the Broussards who are seeing and speaking the most clearly in this case. Perkes talked with Scott Broussard, who called the woman's death a "calculable failure."

"The responsibility for this death is on the medical board, to be shared with Dr. Rutland," Broussard said. "They're supposed to protect the public and they have failed."

Schwarzenegger should take the same action he did when ProPublica and the Los Angeles Times revealed how poorly the California Board of Registered Nursing performs. He should throw the current medical board members out and find people who actually care about protecting the public.

Here is the list of board members who were on the board in 2007 when Rutland's license was reinstated:

Barbara Yaroslavsky
Frank V. Zerunyan
Hedy Chang
John Chin
Shelton Duruisseau
Gary Gitnick
Reginald Low
Mary Lynn Moran
Janet Salomonson
Gerrie Schipske

Call them and ask them why they let Rutland have his license back.

Maurice Clemmons served 10 years in prison for aggravated robbery, and the world was outraged when he shot and killed four police officers.

Rutland served no time for the death of Jillian Broussard. No time for the patients he left injured and scarred for life. Cynthia Conde remains on a breathing tube to this day. William Matthews was born with serious, preventable birth defects. Now an as-yet-unnamed woman is dead because, as the medical board puts it, Rutland administered anesthetic "without knowledge of the safe dosage range or maximum safe dose."

Rutland spent five years biding his time and then was given yet another chance to practice bad medicine.

This, too, deserves some outrage.