Provide a brief synopsis of the story or stories, including any significant findings.

Judges’ comments: Writer Brandon Stahl and the Duluth News Tribune showed exceptional doggedness and courage in chronicling malpractice allegations against one physician and the defense mounted by hospital administrators despite warnings from their own staff. The News Tribune fought vigorously to have records made public and, although confronted by a libel suit, the newspaper continued its reporting. When Konasiewicz moved to Corpus Christi, Texas, Stahl found an ally in a local TV station and was able to identify Texas patients with complaints about the care they'd received. Stahl and the News Tribune then went further, explaining why these patients would not likely be able to sue in Texas because of the impact of tort reform in that state. The coverage showed impressive and laudable commitment by the reporter and the newspaper, and we believe it speaks volumes to the medical community about the media's tenacity when it comes to defending the voiceless.

List date(s) this work was published or aired.

Stories and related stories in this series ran on May 29, May 30, May 31, July 31, Aug. 1, Sept. 21, Sept. 25, Sept. 26, Oct. 1, Oct. 21 and Dec. 28, 2011.

See this entry.

AHCJ resource: Reporter Q&A: Duluth News Tribune exposes malpractice allegations

Provide a brief synopsis of the story or stories, including any significant findings.

During the 10 years he worked at St. Luke's hospital, Dr. Stefan Konasiewicz performed more neurosurgeries than any other doctor in Duluth and became the city's highest-paid physician. Yet he also amassed scores of patient complaints and numerous lawsuits, eventually leading insurance companies to deem him uninsurable. Finally reprimanded by the state medical board for causing permanent patient harm and deaths, Konasiewicz left Minnesota for Texas, where he faced no restrictions on his license. The News Tribune identified nearly 90 cases of alleged patient harm by Konasiewicz, beginning with eight malpractice suits which the hospital settled for at least $3.2 million. The newspaper also showed that St. Luke's, which went from operating at a deficit to a healthy surplus during Konasiewicz's tenure, kept him on staff despite numerous warnings from other physicians about the quality of his care. By going to court to release a sealed document, the News Tribune showed that the state medical board only took action against the physician after a county medical examiner wrote the board asking for an investigation to determine "if Dr. Konasiewicz is incompetent or reckless." Once in Texas, Dr. Konasiewicz continued to garner patient complaints, with more than a dozen alleging harm by him to the News Tribune. Ultimately, he severed ties with his new clinic and was last located setting up corporations in a Texas border town with no clear information on his future plans. St. Luke's hospital and its CEO have responded to the News Tribune series by filing a defamation suit against the paper, in particular taking issue with a heading, "As St. Luke's reaped millions, surgeon racked up complaints"-- two irrefutable facts. The suit is currently in discovery and trial has been scheduled for October 2012.

Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?

Our primary data source on Konasiewicz's malpractice cases was the National Practitioner Data Bank, a record showing how many times a doctor has settled a malpractice suit or been disciplined by the state or a health-care facility. Though the Data Bank does not list a physician's name, we were able to identify Konasiewicz's cases by reviewing hundreds of pages of malpractice lawsuits and cross-referencing that with information in the Data Bank. We were able to determine how many times Konasiewicz had been sued and the amount for which each case was settled. We obtained numerous state and federal hospital inspection reports, which showed no investigation of Konasiewicz's actions at St. Luke's. We uncovered a lawsuit filed by the hospital against a state malpractice insurance provider, with the hospital claiming the provider should have paid more to one of Konasiewicz's alleged victims. Those records revealed that the hospital warned the state carrier of three more cases of alleged harm caused by Konasiewicz. To confirm the harm claimed by Konasiewicz's patients, we relied on the patients' medical records, malpractice records and the disciplinary documents provided by the Minnesota Board of Medical Practice. For financial information on the hospital, we relied on Internal Revenue Service 990 forms and hospital annual reports submitted by the hospital to the state of Minnesota. Those reports provided detailed breakdowns on admissions, malpractice payouts and profit and loss recorded by the hospital and various departments. Finally, the News Tribune went to court to get a crucial document for the series. When the paper learned of the investigation conducted by the St. Louis County medical examiner, the News Tribune requested those records. The county attorney denied access, claiming the records were private data. The News Tribune sued the county attorney for access to a letter the medical examiner wrote to the state medical practice board. A judge sided with the News Tribune and provided the paper with the records, saying that release of the information was "in the public's interest."

Explain types of human sources used.

The News Tribune conducted hundreds of interviews during the course of reporting these stories. We spoke to many physicians and surgical assistants with first-hand knowledge of Konasiewicz's care who said they had complained about him to hospital administration. At first they spoke off the record, but eventually several went on the record to confirm their complaints and concerns. They did so because the News Tribune had done so much research and had gathered data to confirm their initial tips. Another physician who worked at a rival hospital went on record to say that on several occasions he treated patients who suffered complications as a result of Konasiewicz's surgeries. We also relied heavily on the voices of Konasiewicz's patients who said they were hurt or family members who said their loved ones died due to Konasiewicz's care. They were able to provide graphic, compelling detail about how their lives changed after being patients of Konasiewicz. Additionally, we included stories of patients who were pleased with his work and who said their lives would not be the same if not for him.

Results (if any).

The state of Wisconsin restricted Konasiewicz's license on June 15. In October, Konasiewicz resigned from his practice in Corpus Christi, Texas. Since then, Konasiewicz has not reported his primary practice location to any state medical board. That may lead to an investigation by the Texas Board of Medical Practice, which requires physicians to report a new practice location within 30 days. Scores of former patients have contacted the News Tribune to report what they describe as harmful treatment by Konasiewicz. Many express relief at knowing the public is aware of the complaints against the neurosurgeon and knowing that they are not alone in their situation.

Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.

At the advice of our attorneys in an attempt to avoid the costs associated with a lawsuit, on Aug. 21 the News Tribune published the following correction: "A July 31 article regarding St. Luke's hospital stated that the hospital had no peer review program for its neurosurgeons. A letter to the News Tribune dated Aug. from John Strange, St. Luke's president and CEO, outlined that the hospital in fact has a peer review process that covers all of its physicians." The hospital and its CEO sued the News Tribune in October claiming the stories were false and defamatory. The News Tribune has filed a response standing by its reporting and denying the hospital's allegations. The lawsuit is pending. The hospital also began investigating the physicians who went on record with the News Tribune, telling them that talking to us violated hospital bylaws.

Advice to other journalists planning a similar story or project.

These stories required months of work, and a combination of obtaining records, going to court, analyzing data, and getting human sources to go on record with us, even though some were threatened with legal action if they spoke to us. Needless to say, it took perseverance to report these stories. And it took getting every single public record available to us. For example, to determine how to obtain malpractice settlements for the hospital and Konasiewicz, we reviewed numerous court records and cross-referenced those records with the public use file of the National Practitioner Data Bank. The Data Bank is an electronic repository of thousands of malpractice settlements and disciplinary actions taken against physicians, though it omits names of doctors, their practice name and the hospital where they practice. We were able to identify Konasiewicz's settlements in the Data Bank by using information culled from the lawsuits filed against him. Unfortunately, I don't know if it's possible to do that in future stories. The federal agency that administers the Data Bank closed it down for part of 2011, and then re-opened it, but only with the understanding that it wouldn't be used to identify doctors. While getting public records can always be a lengthy and painstaking process, this is the first time the News Tribune sued a government entity and sought a judge's order to obtain records. We paid about $1,300 in court and legal fees to do this. The story based on the records we obtained ran following the lawsuit filed by St. Luke's.