Reporter Q&A: Duluth News Tribune exposes malpractice allegations Date: 08/25/11
By Charles Ornstein
In May, Duluth (Minn.) News Tribune investigations editor Brandon Stahl and courts reporter Mark Stodghill published a major story about how a local neurosurgeon, Stefan Konasiewicz, had amassed a record of malpractice allegations despite praise and high pay from his hospital. Stahl followed up with additional pieces this month about the money the hospital reaped from Konasiewicz's surgical department and the growing list of patients complaining that they were harmed by the doctor.
Stahl has worked at the News Tribune for the past five years and has covered health care, government and politics. Prior to that, he worked as the news editor for the Fergus Falls (Minn.) Daily Journal. Below is an e-mail conversation he had with AHCJ board president Charles Ornstein about how the story came together, how he got local doctors to publicly discuss their complaints about Konasiewicz and the resources he found most helpful.
1) Stefan Konasiewicz moved away from Duluth three years ago. Why and how did you become interested in him more recently?
Though he moved from Duluth in 2008, he wasn't sanctioned by the Minnesota Medical Board until September 2010, prompting our first story. That prompted a group of six doctors to come to us and tell us that there was more to the story that required further investigation. Those physicians (later, along with others) said they repeatedly went to the hospital's senior administration to warn them about Konasiewicz, yet they felt little to nothing was done. They also alleged due to the revenues the doctor was generating, the hospital protected him. That brought one of the region's largest employers, St. Luke's Hospital, into the mix, making the story much more compelling and interesting.
We decided what needed to be told was: the extent of the alleged harm by the doctor, what the hospital knew about the harm, and what, if anything, they did to protect patients.
2) Beginning with your first story, you were able to find doctors (former colleagues of Konasiewicz's) to go on the record with their concerns about him. Physicians are typically reluctant to talk about their colleagues if they know their names will show up in a news report. How did you do it?
It wasn't easy and took a long, long time. At first they were loathe to go on record, citing fear of retaliation from St. Luke's. But for the first story, we were able to quote one, and then in the second able to quote another along with cite a doctor's testimony in a malpractice case that was critical of Konasiewicz. Then we went back to the doctors, as well as other physicians and staff who practiced at the hospital, and asked them to go on record. They knew this was an important story to our community, and we told them that it would be stronger and more powerful if their voices could be used. Eventually, they agreed, and went in depth on what they knew and when they knew it.
3) How did you go about identifying injured patients and verifying their stories?
At first all we had to go on were malpractice records, the majority of which had settled and included confidentiality agreements. But some of the patients who sued and settled agreed to talk, and other lawsuits had such detailed records that we cited those cases. (One of the lawsuits was filed by the hospital against a state insurance provider that covered Konasiewicz. That was crucial in helping us to identify that while at the hospital Konasiewicz could no longer get private insurance because he was considered too much of a liability.)
After our first set of stories, patients who hadn't sued began coming to us. To quote them, we verified that that what we they were telling us was true by examining their medical records, some of which referenced Konasiewicz's care extensively.
4) Tell me how you used the National Practitioner Data Bank to find malpractice payouts involving him? The database does not include physician names and is intended to prevent the public from looking up a specific doctor. So how did you figure it out?
True, the databank doesn't have physician names (or hospital) it does give some details of a physician: the decade of birth, the decade the physician went to medical school, and the state he/she practices. It also has information about a malpractice case, including the allegation of the malpractice and outcome (death, serious injury, minor injury, etc.). Using that information, we identified Konasiewicz's "practnum" in the data bank - the specific number that identified him. Using that number, we then found all of his citations in the databank, which allowed us to get an idea of how much in settlements the doctor and hospital have paid out - numbers that typically aren't revealed in court records.
5) Your second story talks about the money the hospital made off neurosurgery. Why was this angle important and how did you nail it down?
Many doctors and staff told us that the perception among those working at the hospital was that despite concerns being raised about his care, Konasiewicz continued to practice because of the revenue he was generating.
While 990s provide an overall picture of a hospital's revenues, those aren't broken down by department (though they did provide us with Konasiewicz's salary). Fortunately, the state of Minnesota requires hospitals to file Hospital Annual Reports, wonderfully detailed financial data that provides how much revenue is generated by nearly every department in the hospital, as well as the number of surgeries performed. That data went back to 1995, and at that time was more limited. But as the years went on, the data became much more detailed, allowing for a better picture.
6) Were you surprised that after your initial story, so many more patients contacted you to share their stories? Was this more or less than you expected?
I think the better word was overwhelmed. Particularly after the second set of stories, my phone seemingly didn't stop ringing with patient after patient telling me of an alleged horror story about Dr. Konasiewicz. We've now identified 64 patients who claim they were harmed by the doctor.
7) What has been the reaction from the hospital? Patients? The medical community at large?
The hospital has said nothing publicly. The community has by and large reacted very well to these stories, praising us for shedding light on the issue.
8) Konasiewicz is now practicing in Texas. Have your stories impacted his license there or his work?
At this point, no, as he practices in Texas without any restrictions on his license. However, a TV station in Corpus Christi picked up on our stories and ran their own last week. Since then, we've talked with five patients down there, and have reached out to others. We've also been told that attorneys are considering filing lawsuits against the doctor on behalf of patients who have come to them.