Doctors Behaving Badly: Doc's solo flights leave patients plummeting with no chute

The best doctors know their limits. General practitioners trust radiologists to read X-rays, pathologists to interpret lab results. Pulmonologists call oncologists if they suspect cancer. Obstetricians send patients to nutritionists to make sure they are eating the right foods during a pregnancy.

And then there are doctors who like to fly solo.

Dr. Perry Hearn, a 51-year-old family practice doctor in Norwell, Massachusetts, has had a history of going it alone, to the detriment of his patients.

In March 2001, he was working in the ER at Milton Hospital when a 21-year-old woman arrived complaining of nausea and pelvic pain. Hearn immediately prescribed injections of Demerol and Vistaril.

This was his first mistake, according to the Massachusetts Board of Registration in Medicine. By drugging the woman, Hearn masked her symptoms and made it more difficult to discern the cause of her problem. Ruptured appendix? Bladder infection? Who knows?

Hearn should have performed a pelvic exam, the board says, but did not. Instead, he kept giving her painkillers and discharged her with a diagnosis of food poisoning.

This was his second mistake, the board says. He should have known his limits and asked for help from a gynecologist or a surgeon. Instead, the young woman's symptoms only worsened. After four days of "persistent pain and vomiting," according to the board, she was brought into the Emergency Department of Children's Hospital in Boston. The doctors there found what a gynecologist likely would have found had Hearn called one in: the patient had a swollen ovary with several cysts. Her left ovary and fallopian tube had to be removed.

The board says, cryptically, "As a result of this incident, Hearn no longer practices emergency medicine."

He did, however, continue seeing patients in his office. In June 2004, a regular patient of Hearn's came in complaining of coughing and chest pain. At age 88, the patient's blood pressure was high enough to send off alarm bells. The patient, as the board notes, had a "history of advanced coronary artery disease, cardiomyopathy, congestive heart failure, atrial fibrillation and high blood pressure." He had been seeing a cardiologist, who had prescribed four different heart-related medications.

Instead of calling that cardiologist, Hearn took the patient off three of the drugs and told the patient to monitor his own blood pressure and restart two of the drugs if the blood pressure hit certain limits. Over the next six weeks, Hearn saw the patient 11 times, but during none of these visits did he check the patient's blood pressure, weight or even his pulse. Had he checked these things, the board says, he would have found that the patient's heart rate was speeding up, he was gaining weight and his atrial fibrillation was getting worse.

The day after the patient's last visit with Hearn, the patient was hospitalized with "acute heart failure," the board says. He was immediately put back on all the drugs that Hearn had discontinued. It was too late. He died two weeks later.

These are just the cases that caught the attention of the medical board. In 2007, Hearn agreed to pay $150,000 to settle a federal case that accused him of submitting false claims to Medicare and Medicaid. That same year, he also was accused during a trial of being connected to a doctor allegedly running a painkiller mill, an accusation that Hearn disputed during the trial, saying that he had stopped treating pain patients in 2003. Hearn also has been licensed in Maine, Georgia and Florida but those states offer little information online about his work there.

Because of the woman with the diseased ovary and the patient who died of a heart attack, Hearn was notified by the Massachusetts medical board that he faced disciplinary action. This time Hearn picked up the phone. He cut a deal with the board in which he agreed to the facts laid out in those cases but faced much less discipline than a doctor typically would for a pattern of behavior that led to a patient's death. In January 2010, he was given a reprimand, told to attend 40 credits of Continuing Medical Education, and required to have his practice audited by a private firm, Affiliated Monitors, Inc.

Final question: Why would the Massachusetts board make it so hard for patients to find out why Hearn was disciplined? The board deserves praise for such an easy to find and detailed "Physician Profile" page. It notes, for example, that Hearn is in a small minority of family practice doctors who have been forced to make malpractice payments in the past 10 years. Only 5% of the 1,739 licensed family practice doctors in the state have made payments, and Hearn has had to pay twice.

The profile page ends with the note that Hearn has been the subject of a reprimand. In tiny type at the bottom of the page, a note tells patients to call the board for additional information at 1-800-377-0550. In reality, finding the details about Hearn requires just a little more time bumbling around the website. Those details reside under the "Other Board Information" section in the "Public Information" area. Click on "Disciplinary and Other Board Actions" and you will see three documents related to Hearn. Why not link those directly to the Physician Profiles? Save patients the time and frustration.